Yoo, Sang Hoon;Lee, Jae Ha;Yoo, Kwang Ha;Jung, Ki-Suck;Rhee, Chin Kook
Tuberculosis and Respiratory Diseases
/
v.81
no.3
/
pp.228-232
/
2018
Background: Chronic bronchitis (CB) is an important phenotype in chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate different pattern of COPD assessment test (CAT) score between CB and non-CB patients. Methods: Patients were recruited from 45 centers in Korea, as part of the Korean COPD Subgroup Study cohort. CB was defined when sputum continued for at least 3 months. Results: Total 958 patients with COPD were eligible for analysis. Among enrolled patients, 328 (34.2%) were compatible with CB. The CAT score was significantly higher in patients with CB than non-CB, and each component of CAT score showed a similar result. CB was significantly associated with CAT score when adjusted with age, sex, modified Medical Research Council, and post-bronchodilator forced expiratory volume in 1 second. Each component of CAT score between patients with CB and non-CB showed different pattern according to Global Initiative for Chronic Obstructive Lung Disease grade. Conclusion: CAT score is significantly higher in patients with CB than non-CB. Each component of CAT score was significantly different between two groups.
Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.
Park, Won-Hyoung;Jang, In-Seok;Kim, Chang-Jin;Kwon, Do-Hoon
Journal of Korean Neurosurgical Society
/
v.46
no.4
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pp.360-364
/
2009
Objective : Several treatment options have proven effective for metastatic brain tumors, including surgery and stereotactic radiosurgery. Tumors with cystic components, however, are difficult to treat using a single method. We retrospectively assessed the outcome and efficacy of gamma knife radiosurgery (GKRS) for cystic brain metastases after stereotactic aspiration of cystic components to decrease the tumor volume. Methods : The study population consisted of 24 patients (13 males, 11 females; mean age, 58.3 years) with cystic metastatic brain tumors treated from January 2002 to August 2008. Non-small cell lung cancer was the most common primary origin. After Leksell stereotactic frame was positioned on each patient, magnetic resonance images (MRI)-guided stereotactic cyst aspiration and GKRS were performed (mean prescription dose : 20.2 Gy). After treatment, patients were evaluated by MRI every 3 or 4 months. Results : After treatment, 13 patients (54.2%) demonstrated tumor control, 5 patients (20.8%) showed local tumor progression, and 6 patients (25.0%) showed remote progression. Mean follow-up duration was 13.1 months. During this period, 10 patients (41.7%) died, but only 1 patient (4.2%) died from brain metastases. The overall median survival after these procedures was 17.8 months. Conclusion : These results support the usefulness of GKRS after stereotactic cyst aspiration in patients with large cystic brain metastases. This method is especially effective for the patients whose general condition is very poor for general anesthesia and those with metastatic brain tumors located in eloquent areas.
Journal of International Academy of Physical Therapy Research
/
v.6
no.1
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pp.795-801
/
2015
The purpose of this study was to find out an inspiratory muscles training program's therapeutic effects on stroke patients' respiratory function. For the purpose, this study targeted 20 stroke patients being hospitalized in K hospital in Daegu, and diveded the patients into the both groups of Inspiratory muscle training(IMT) group and control group, randomization. The 10 patients in the IMT group was applied the inspiratory muscles training. The control group was composed of other 10 patients. IMT group was given a inspiratory muscle training program for 30 minutes per times, 5 times a week for 6 weeks. The investigator measured the patients' respiratory function compared changes in the function and ability before and after the IMT. The results of this study are as follows. Investigating the inspiratory muscle training group's lung functions, there appeared some significant differences in the tests the FVC(Forced vital capacity), FEV1(Forced expired volume in one second) before and after the training(p<.05), but the control group had no significant in the same tests before and after(p<.05). The differences in the both groups after depending the inspiratory muscles training were significantly found in the tests of FVC, FEV1, FEV1/FVC(p<.05). The maximum inspiratory pressure showed some significant differences in the inspiratory muscle training group(p<.05), but didn't show any significant difference in the control group(p>.05). Conclusionally, it will be judged that the inspiratory muscles training program will improve stroke patients' respiratory function, and it is considered that will move up stroke patients' gait and body function.
In the present study, we developed a nuclear stethoscope interfaced with a personal computer (APPLE- II) and evaluated it's performances as compared with the gamma camera. This single-probe, ECG-gated system has been used for displaying the left ventricular time-activity curves, the peak ejection time and its rate, the peak filling time and its rate, and the R-R interval distribution. The radioactivity was measured at every 10msec around the ventricular region, where the activity curves shows the maximal peak to peak variations. The background activity was measured around the lung area showing its counts approximately 50% of the end-diastolic count with minimal variations. The average time-activity curves of 100 beats were used for analysis in the equilibrium study after intravenous injection of 15-20mCi of Tc. The ejection fractions measured by the nuclear stethoscope(Y) were compared with those measured by gamma camera(X) in 47 patients with various heart diseases. The correlation coefficient between two measurements was 0.766 with a relation of Y=1.04 x-8.48. Also, the high reproducibility was obtained for the same patient. Also, the high reproducibility was obtained for the same patient. From this study, we conclude that this device is useful for continuous monitoring in the intensive care unit, as it is portable, compact, and inexpensive.
Background Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles. Methods A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain. Results Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area. Conclusions Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake.
Yang, Andrew Jihoon;Choi, Seo Hee;Byun, Hwa Kyung;Kim, Hyun Ju;Lee, Chang Geol;Cho, Jaeho
Radiation Oncology Journal
/
v.37
no.3
/
pp.193-200
/
2019
Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD2). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD2) were significantly associated with OS. The high dose group (≥52 Gy, EQD2) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.
Taurine, 2-aminoethanesulfonic acid is widely distributed in animal tissues and has a variety of bio-logical activities. A recent worldwide study demonstrated beneficial effects of taurine on aging and age-associated disorders. In general, taurine levels in the brain decease when an animal is subjected to pathologic conditions such as ischemia-anoxia and seizure. But the taurine levles tend to increase in the brain in hypertensive state. In the present study, the blood-brain barrier (BBB) transport of [$^3$H]taurine was compared between spontaneously hypertensive rats (SHR) and normotensive Sprague-Dawley rats (SD) using intravenous injection technique in vivo. We also obtained pharmacokinetic parameters of plasma volume maker, [$^{14}$ C] sucrose and [$^3$H]taurine after inject to rats simulatenously. BBB permeability surface area product (PS) value of [$^3$H]taurine in SHR (16$\pm$2.9$\times$10$^{-3}$ ml/min/g) was significantly higher than that in SD (7.4$\pm$0.8$\times$10$^{-3}$ ml/min/g). There is also significant difference for brain uptake of [$^3$H]taurine between SHR (0.195$\pm$0.031%ID/g) and SD (0.058$\pm$0.003% ID/g). This is due to difference of area under the plasma concentration-time curve (AUC) and that of total clearance (Class) between SHR and SD. No significant difference was indicated from other organ uptakes such as lung, heart, liver SHR and SD. But also kidney uptake was much higher in SHR. In conclusion, [$^3$H]taurine in plasma was slowly eliminated in SHR than in SD and uptake of [$^3$H]taurine in SHR is much higher than that of SD. This results suggest increased taurine level in the brain in hypertension state have an any effect on the brain uptake of taurine.
Maximal expiratory flow-volume [MEFV] curves were studied in 22 patients who underwent pneumonectomy with various pulmonary lesions, such as lung cancer, bronchiectasis and tuberculosis etc, at the preoperative stage and 3 week, 4 month and 12 month after pneumonectomy for the analysis of the reduction and progressive improvement of postoperative ventilatory function. And the factors affecting them like as age difference and the site of pneumonectomy were also analyzed. From these curves peak flow rate [PF R], maximal expiratory flows at 25% and 50% of expired forced vital capacity [V25, V50] and forced vital capacity [FVC] were obtained. In addition, partial pressure of oxygen and carbon dioxide in arterial blood were measured. The results were as follows; 1. The mixed type, especially obstructive type of ventilatory impairment was observed at 3 week after operation. For 1 year of postpneumonectomy FVC was increased by 12.3% of predicted compared to 2.6% of predicted V50. 2. The improvement of FVC during 1 year of postpneumonectomy showed decreasing tendency with the increase of age but the changes of V25 and V50 were unremarkable. 3. The differences of immediate postoperative reduction and progressive improvement of ventilatory capacity after right and left pneumonectomy were analyzed. The reduction of V50, V25 and FVC at 3 week of postoperation were greater in patients with right pneumonectomy [20.9%, 18.2% and 26.2% of predicted] than in patients with left pneumonectomy 16.5%, 18.2% and 18.1%]. But there was no significant difference of these values at 12 month after pneumonectomy. 4. The partial pressure of oxygen in arterial blood [$PaO_2$] was decreased by 13.6 mmHg at 3 week after pneumonectomy compared to the preoperative stage but returned to the normal range within 4 month after pneumonectomy. However, TEX>$PaCO_2$ was within the normal range during 1 year of postoperation.
Postpneumonectomy syndrome is a rare complication that usually occurs in younger patients within the first year after a right total lung resection. Its clinical presentations are stridor, dyspnea, and recurrent pulmonary infections. An airway obstruction secondary to the extreme mediastinal shift and ratation after a pneumonectomy is the main mechanism. It is commonly complicated with tracheobronchomalacia due to longstanding airway compression. The management modalities involve a repositioning of the mediastinum with volume expansion of the pneumonectomy site by a expandable prosthesis. however, other methods including an endobronchial stent insertion should be considered in the presence of a tracheobronchomalacia or in poor surgical candidates. Here we describe a case of postpneumonectomy syndrome complicated by a bronchomalacia, which was successfully treated with a self-expandable endobronchal stent.
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