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Clinical investigation of lipoid pneumonia in adults (성인에서 발생한 지방성 폐렴의 임상적 고찰)

  • Hyun, Jae Geun;Rhee, Chong H.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.965-975
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    • 1996
  • Background : Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 10 July 1996, were included. They hadn a history of laking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients look 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X - ray. The major radiologic findings by simple chest X - ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and Lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X -ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene". Conclusion: Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

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Two Cases of Chemical Pneumonitis Caused by Hydrogen Sulfide (황화수소로 인한 화학성 폐렴 2예)

  • Kim, Jung Ha;Lee, Kyung Joo;Jung, Jin Yong;Lee, Eun Joo;Jung, Ki Hwan;Kang, Eun Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.210-214
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    • 2008
  • Chemical pneumonitis is an occupational lung disease that's caused by the inhalation of chemical substances. Its severity depends on the characteristics of the substances, the exposure time and the susceptibility of the patients. Hydrogen sulfide is not only emitted naturally, but it also frequently found in industrial settings where it is either used as a reactant or it is a by-product of manufacturing or industrial processes. Inhalation of hydrogen sulfide causes various respiratory reactions from cough to acute respiratory failure, depending on the severity. Two pharmaceutical factory workers were admitted after being rescued from a waste water disposal site that contained hydrogen sulfide. In spite that they recovered their consciousness, they had excessive cough and mild dyspnea. The simple chest radiographs and high resolution computed tomography showed diffuse interstitial infiltrates, and hypoxemia was present. They were diagnosed as suffering from chemical pneumonitis caused by hydrogen sulfide. After conservative management that included oxygen therapy, their symptoms, hypoxemia and radiographic abnormalities were improved.

Clinical and Radiological Characteristics of Non-Tuberculous Bronchial Anthracofibrosis (비결핵성 기관지탄분섬유증의 임상적 특징과 방사선학적 특징)

  • Jang, See Jin;Lee, Sook Young;Kim, Suk Chan;Lee, So Young;Cho, Hyun Sun;Park, Ki Hoon;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Kim, Young Kyoon;Park, Hyun Jin
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.139-144
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    • 2007
  • Background: Bronchial anthracofibrosis, which is defined as bronchial narrowing with black pigmentation of the overlying bronchial mucosa, is frequently associated with tuberculosis. The aim of this study was to examine the relationship between bronchial anthrocofibrosis and to identify the clinical and radiological characteristics of non-tuberculous bronchial anthracofibrosis. Methods: All patients who showed bronchial anthracofibrosis in more than one segment on a bronchoscopic examination from January 2003 to July 2006 at Kangnam St. Mary's hospital were enrolled in this study. The underlying diseases, baseline clinical characteristics, characteristic findings on a computed tomogram (CT) of the chest, pathologic findings of the bronchial mucosa, and the clinical response to steroid therapy were analyzed retrospectively. Results: A total 54 patients (19 males, 35 females) were enrolled with a mean age of 75 years. The most common presenting symptoms were cough, sputum and dyspnea. The predominant X-ray findings were peribronchial soft tissue attenuation with or without calcification, mediastinal lymphadenopathy with or without calcification and atelectasis. Fourteen non-tuberculous anthracofibrosis patients were treated with steroid. Nine patients were improved clinically, and 6 patients were improved radiologically. Conclusion: Bronchial anthracofibrosis is frequently associated with various pulmonary diseases not only tuberculosis but also COPD pneumonia etc.

Characteristics of the Early Growth for Korean White Pine(Pinus koraiensis Sieb. et Zucc.) and Effects of Local Climatic Conditions on the Growth -Relation between Periodic Annual Increment and Local Climatic Conditions- (지역별(地域別) 잣나무의 초기생장(初期生長) 특성(特性)과 미기후(微氣候)의 영향(影響) - 정기평균생장량(定期平均生長量)과 미기후(微氣候)와의 관계(關係) -)

  • Chon, Sang-Keun;Shin, Man Yong;Chung, Dong-Jun;Jang, Yong-Seok;Kim, Myung-Soo
    • Journal of Korean Society of Forest Science
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    • v.88 no.1
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    • pp.73-85
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    • 1999
  • This study was conducted to reveal the characteristics of the early growth by locality for Korean white pine planted in Gapyung and Kwangju, Kyunggi-Do and Youngdong, Choongchungbuk-Do. The effects of local climatic conditions as one of environmental factors on the growth were also analyzed. For this, several stand variables such as number of trees survived, mean DBH, mean height, basal area per hectare, and volume per hectare by stand age were measured and summarized for each locality. Based on these statistics, periodic annual increments for 8 years from stand age 10 to 18 were calculated for each of stand variables. A topoclimatological technique, for the estimation of local climatic conditions, which makes use of empirical relationships between the topography and the weather in study areas was applied to produce reasonable estimates of monthly mean, maximum, minimum temperatures, relative humidity, precipitation, and hours of sunshine over remote land area where routine observations are rare. From these monthly estimates, 17 weather variables such as warmth index, coldness index, index of aridity etc. which affect the tree growth, were computed for each locality. The periodic annual increments were then correlated with and regressed on the weather variables to examine effects of local weather conditions on the growth. Gapyung area provided the best conditions for the growth of Korean white pine in the early stage and Kwangju area ranked second. On the other hand, the growth pattern in Youngdong ranked last overall as expected. It is also found that the local growth patterns of Korean white pine in juvenile stage were affected by typical weather conditions. The conditions such as low temperature, high relative humidity, and large amount of precipitation provide favorable environment for the growth of Korean white pine. Especially, the diameter growth, basal area growth, and volume growth are mainly influenced by the amount of precipitation. However, it is proved that the height growth is affected by both the precipitation and temperature.

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A Reliability Analysis of Shallow Foundations using a Single-Mode Performance Function (단일형 거동함수에 의한 얕은 기초의 신뢰도 해석 -임해퇴적층의 토성자료를 중심으로-)

  • 김용필;임병조
    • Geotechnical Engineering
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    • v.2 no.1
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    • pp.27-44
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    • 1986
  • The measured soil data are analyzed to the descriptive statistics and classified into the four models of uncorrelated-normal (UNNO), uncorrelated-nonnormal (VNNN), correlatedonnormal(CONN), and correlated-nonnormal(CONN) . This paper presents the comparisons of reliability index and check points using the advanced first-order second-moment method with respect to the four models as well as BASIC Program. A sin91e-mode Performance function is consisted of the basic design variables of bearing capacity and settlements on shallow foundations and input the above analyzed soil informations. The main conclusions obtained in this study are summarized as follows: 1. In the bearing capacity mode, cohesion and bearing-capacity factors by C-U test are accepted for normal and lognormal distribution, respectively, and negatively low correlated to each other. Since the reliability index of the CONN model is the lowest one of the four model, which could be recommended a reliability.based design, whereas the other model might overestimate the geotechnical conditions. 2. In the case of settlements mode, the virgin compression ratio and preccnsolidation pressure are fitted for normal and lognormal distribution, respectively. Constraining settlements to the lower ones computed by deterministic method, The CONN model is the lowest reliability of the four models.

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The effects of physical factors in SPECT (물리적 요소가 SPECT 영상에 미치는 영향)

  • 손혜경;김희중;나상균;이희경
    • Progress in Medical Physics
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    • v.7 no.1
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    • pp.65-77
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    • 1996
  • Using the 2-D and 3-D Hoffman brain phantom, 3-D Jaszczak phantom and Single Photon Emission Computed Tomography, the effects of data acquisition parameter, attenuation, noise, scatter and reconstruction algorithm on image quantitation as well as image quality were studied. For the data acquisition parameters, the images were acquired by changing the increment angle of rotation and the radius. The less increment angle of rotation resulted in superior image quality. Smaller radius from the center of rotation gave better image quality, since the resolution degraded as increasing the distance from detector to object increased. Using the flood data in Jaszczak phantom, the optimal attenuation coefficients were derived as 0.12cm$\^$-1/ for all collimators. Consequently, the all images were corrected for attenuation using the derived attenuation coefficients. It showed concave line profile without attenuation correction and flat line profile with attenuation correction in flood data obtained with jaszczak phantom. And the attenuation correction improved both image qulity and image quantitation. To study the effects of noise, the images were acquired for 1min, 2min, 5min, 10min, and 20min. The 20min image showed much better noise characteristics than 1min image indicating that increasing the counting time reduces the noise characteristics which follow the Poisson distribution. The images were also acquired using dual-energy windows, one for main photopeak and another one for scatter peak. The images were then compared with and without scatter correction. Scatter correction improved image quality so that the cold sphere and bar pattern in Jaszczak phantom were clearly visualized. Scatter correction was also applied to 3-D Hoffman brain phantom and resulted in better image quality. In conclusion, the SPECT images were significantly affected by the factors of data acquisition parameter, attenuation, noise, scatter, and reconstruction algorithm and these factors must be optimized or corrected to obtain the useful SPECT data in clinical applications.

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Feasibility and Efficacy of Adaptive Intensity Modulated Radiotherapy Planning according to Tumor Volume Change in Early Stage Non-small Cell Lung Cancer with Stereotactic Body Radiotherapy (폐암의 정위적체부방사선치료에서 육안적종양체적 변화에 따른 적응방사선치료의 효용성 및 가능성 연구)

  • Park, Jae Won;Kang, Min Kyu;Yea, Ji Woon
    • Progress in Medical Physics
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    • v.26 no.2
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    • pp.79-86
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    • 2015
  • The purpose of this study is to evaluate efficacy and feasibility of adaptive radiotherapy according to tumor volume change (TVC) in early stage non-small cell lung cancer (NSCLC) using stereotactic body radiotherapy (SBRT). Twenty-two lesions previously treated with SBRT were selected. SBRT was usually performed with a total dose of 48 Gy or 60 Gy in four fractions with an interval of three to four days between treatments. For evaluation of TVC, gross tumor volume (GTV) was contoured on each cone-beam computed tomography (CBCT) image used for image guidance. Intensity modulated radiotherapy (IMRT) planning was performed in the first CBCT (CBCT1) using a baseline plan. For ART planning (ART), re-optimization was performed at $2^{nd}$, $3^{rd}$, and $4^{th}$ CBCTs (CBCT2, CBCT3, and CBCT4) using the same angle and constraint used for the baseline plan. The ART plan was compared with the non-ART plan, which generated copying of the baseline plan to other CBCTs. Average GTV volume was 10.7 cc. Average TVC was -1.5%, 7.3%, and -25.1% in CBCT2, CBCT3, and CBCT4 and the TVC after CBCT3 was significant (p<0.05). However, the nine lesions were increased GTV in CBCT2. In the ART plan, $V_{20\;Gy}$, $D_{1500\;cc}$, and $D_{1000\;cc}$ of lung were significantly decreased (p<0.05), and $V_{30\;Gy}$ and $V_{32\;Gy}$ of the chest wall were also decreased (p<0.05). While D min of planning target volume (PTV) decreased by 8.3% in the non-ART plan of CBCT2 compared with the baseline plan in lesions with increased tumor size (p=0.021), PTV coverage was not compromised in the ART plan. Based on this result, use of the ART plan may improve target coverage and OAR saving. Thus ART using CBCT should be considered in early stage NSCLC with SBRT.

The Feasibility Study of MRI-based Radiotherapy Treatment Planning Using Look Up Table (Look Up Table을 이용한 자기공명영상 기반 방사선 치료계획의 타당성 분석 연구)

  • Kim, Shin-Wook;Shin, Hun-Joo;Lee, Young-Kyu;Seo, Jae-Hyuk;Lee, Gi-Woong;Park, Hyeong-Wook;Lee, Jae-Choon;Kim, Ae-Ran;Kim, Ji-Na;Kim, Myong-Ho;Kay, Chul-Seung;Jang, Hong-Seok;Kang, Young-Nam
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.237-242
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    • 2013
  • In the intracranial regions, an accurate delineation of the target volume has been difficult with only the CT data due to poor soft tissue contrast of CT images. Therefore, the magnetic resonance images (MRI) for the delineation of the target volumes were widely used. To calculate dose distributions with MRI-based RTP, the electron density (ED) mapping concept from the diagnostic CT images and the pseudo CT concept from the MRI were introduced. In this study, the look up table (LUT) from the fifteen patients' diagnostic brain MRI images was created to verify the feasibility of MRI-based RTP. The dose distributions from the MRI-based calculations were compared to the original CT-based calculation. One MRI set has ED information from LUT (lMRI). Another set was generated with voxel values assigned with a homogeneous density of water (wMRI). A simple plan with a single anterior 6MV one portal was applied to the CT, lMRI, and wMRI. Depending on the patient's target geometry for the 3D conformal plan, 6MV photon beams and from two to five gantry portals were used. The differences of the dose distribution and DVH between the lMRI based and CT-based plan were smaller than the wMRI-based plan. The dose difference of wMRI vs. lMRI was measured as 91 cGy vs. 57 cGy at maximum dose, 74 cGt vs. 42 cGy at mean dose, and 94 cGy vs. 53 at minimum dose. The differences of maximum dose, minimum dose, and mean dose of the wMRI-based plan were lower than the lMRI-based plan, because the air cavity was not calculated in the wMRI-based plan. These results prove the feasibility of the lMRI-based planning for brain tumor radiation therapy.

Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma (악성흉막중피종의 병기판정에서 자기공명영상의 진단적 유용성 평가)

  • Lee, Eunsol;Chae, Eun Jin;Kang, Sunji;Yeom, Yoo Kyeong;Lee, Hyun Joo;Park, Jong Chun;Shin, So Youn;Choi, Yoon Young;Choi, Joon Ho;Do, Kyung-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.232-238
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    • 2013
  • Purpose : We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). Materials and Methods: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. Results: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/ 20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. Conclusion: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.

A Study of the Attitudes of Nonpsychiatric Registered Nurses towards Mental illness and Mental Patients (비정신과 간호원의 정신질환 및 정신질환자에 대한 태도 조사 연구)

  • 박예숙
    • Journal of Korean Academy of Nursing
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    • v.3 no.2
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    • pp.31-43
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    • 1973
  • The trend in modern nursing is toward the performance of comprehensive nursing care. Psychiatric nursing emphasizes education which enables the nurse to understand the underlying difficulties being expressed through a wide range of emotions and through practice to be more adept in her selection of a manner of approach which best meets the needs of a given situation. Presently, in Korea, there is nothing in the literature regarding evaluation of the effect of psychiatric nursing education on the attitudes of nurses towards mental illness and mentally ill patients. This stud!1 was attempted in order to understand 1) some of the problems in psychiatric nursing education 2) some of tile factors which affect the attitudes of nurses towards mental illness and mental patients. A questionnaire, a Korean translation of the "Opinions about Mental illness Scale" by Cohen and Stranding, 1962, was administered to 188 nonpsychiatric registered nurses employed in Yonsei University Hospital (Y. Hospital) and Seoul National University Hospital (S. Hospital) located in the city of Seoul. All of the nurses were directly involved with adult patient care. They graduated from various nursing schools. The data was collected during the period of October 2 to October 16,1972. The age, educational background , marital status, type of previous psychiatric experience, experience as a graduate nurse and close personal relationship with someone who was a psychiatric patient were compared with the O.M.I. scores. The mean and standard errors for each of the comparison groups were computed and tile relationships calculated by a t-test. The results of the study are summarized as follow: 1. There is no significant difference between the age of the nurses and their attitudes toward mental illness and mental patients. 2. There is no significant difference between the. educational backgrounds of the nurses and their attitudes toward mental illness and mental patients. 3. There is a significant difference in the nurses ′student psychiatric nursing experience and their attitudes towards mental illness and mental patients for the nurses in 5. Hospital only. The nurses who had 3-4 week of student psychiatric nursing experience had a significantly higher mean score for Benevolence (factor B) than nurses whose student psychiatric experience had been less than 1 Ivcek (P<0.05). The nurses who had 1-2 weeks, 3-4 weeks and more than 4 weeks of student psychiatric nursing experience had significantly higher mean scores for Interpersonal Ethology (factor E) than nurses whose student psychiatric had been less than 1 week (p<0.05), 4. There is a significant difference in the nurses′student psychiatric nursing experience by types of institution and their attitudes towards mental illness and mental patients for S. Hospital nurses only. The nurses who had their student psychiatric nursing experience in the government psychiatric hospitals recorded significantly higher mean score for Authoritarianism (factor A) than nurses who had their. experience in private psychiatric hospitals (p<0.05). 5. There is no significant difference in the nurses′psychiatric nursing experience as a graduate nurse and their attitudes toward mental illness and mental patients. 6. There is no significant difference in the nature and variety of the nurses′experience as a graduate nurse and their attitude toward mental illness and mental patients. 7. There is no significant difference in the presence or absence of a close personal relationship with a mentally ill person and the nurses′attitude toward mental illness and mental patients. 8. There is no significant difference in the nurses′ marital status and their attitude toward mental illness and mental patients. 9. There is no significant difference between the nurses who were employed ill S. and Y. hospitals and their attitudes towards mental illness and mental patients. Major suggestion for further study was to have more larger and wider scale research for establishing of the reliability and validity of the Korean translation of the O.H.I. Scale.

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