• 동의생리병리학회지
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• 제23권3호
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• pp.710-714
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• 2009

Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

• Journal of Chest Surgery
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• 제29권4호
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• pp.414-419
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• 1996

본 고려대학교 흉부외과 교실에서는 1990년부터 1994년까지 악성흡수로 진단된 81명을 대상으로 악 성흥수의 임상적 인 증상과 원인을 살펴보고, 이 중 64명을 대상으로 화학적 흥막유착술을 실시하여 그 결과를 관찰하였다. 악성흥수의 가장 많은 원인 질환은 남녀 (27세 ∼82세)모두 폐암으로 50 % 의 빈도를 보였고, 가장 흔 한 증상으로는 호흡기 증상이 였다. 화학적 흥막유착술을 실시한 환자의 평균시술횟수는 4회이 였으며, 1달 이내 흥수가 재발하지 않은 단 기간반웅성공율은 92 % 였고, 1달 이상 흥수의 재발이 없었던 장기간 반응성공율은 94 %로 다른 scler- osant보다 높은 성공률을 볼 수 있었다 또한, 화학적흥막유착술을 실시한 후 발생한 부작용은 주로 발 열과 통증으로 이는 비스테로이드성 소염진통제를 투여하여 조절할 수 있었다 악성흥수의 치료에 OK-4)2로 화학적 흥막유착술을 실시하여 좋은 결과를 얻었기에 이에 보고하는 바이다.

• Journal of Chest Surgery
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• 제26권4호
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• pp.298-302
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• 1993

The 40 patients who admitted with chief complaints of pleural effusion and were performed closed thoracostomy and pleural biopsy at the same time with only one incision during the period from Mar,1990. To Feb. 1992. At the department of Thoracic & Cardiovascular Surgery; HanYang University were reviewed retrospectively and the results are as follows: 1. The age of patients ranged from 16 to 73-years old [Mean 44.3-years old]. The peak incidence was fifth decade [25 %] and the next was third decades [22.5 %]. 2. 28 patients were male and 12 patients were female with male preponderance[More than 2 times]. 3. The etiologic of pleural effusion were 25 cases of pulmonary tuberculosis[62.5 %], 8 cases of empyema [20 %], and 7 cases of malignant diseases [17.5 %]. 4. The most common chief complaints were dyspnea[21 cases:29.2%], chest discomfort[16 cases:22.2%], and the coughing with sputum [12 cases: 16.7 %]. 5. The duration of symptom were varied from 3 days to lyear [Mean 3.2 weeks]. 6. The amounts of drained pleural effusion after closed thoracostomy were ranged from 100ml to 2,400 ml [Mean 650 ml], but the amounts in case of malignant pleural effusion were varied from 400ml to 1,700ml [Mean 950ml]. 7. The diagnostic rate was 84.6 % with routine examination of tuberculous pleural effusion [Lymphocyte predominance] and the same rate was acquired by pleural biopsy. 8. The diagnostic rate by pleural biopsy in case of malignant pleural effusion was 57.1% and lower than tuberculous pleural effusion. 9. The etiology of malignant pleural effusion were squamous cell carcinoma [3 cases:42.8 %], adenocarcinoma [2 cases:28.6 %] and metasiatic breast cancer [1 case:14.3%].

• Tuberculosis and Respiratory Diseases
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• 제45권2호
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• pp.388-396
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• 1998

연구배경: 흉수의 원인을 규명하는 방법으로는 임상소견, 흉수 분석, 그리고 흉막생검 등이 있다. 그러나 이와 같은 적극적인 검사에도 불구하고 약 20%의 환자에서 흉수의 원인을 모르는 것으로 알려져 있다. 결핵성 흉막염은 우리나라에서 가장 흔히 보는 흉막질환이지만 흉수에서 결핵균 양성율은 20-30%에 불과하고 흉막생검 양성율도 50%를 넘지 않아 감별진단이 어려운 경우를 임상에서 종종 경험하게 된다. 본 연구에서는 흉수의 감별진단에 있어 흉수에서의 ADA(adenosine deaminase) 및 동종효소의 활성도 측정의 유용성을 평가하고자 하였다. 방 법: 1996년 1월 부터 6월까지 단국대병원 내과에 흉수로 입원한 54명의 환자들의 흉수와 혈청에 대해 ADA 및 동종효소의 활성도를 측정하였다. 흉수의 원인으로는 결핵성 흉수가 25명, 부폐렴성 흉수가 10명, 악성 흉수가 14명, 여출성 흉수가 5명이었으며, 이들 중 소방형 흉수를 보인 경우는 결핵성 흉수가 5명, 부폐렴성 흉수가 6명이었다. 총 ADA 활성도와 동종효소 활성도 측정은 spectrophotometry로 시행하였으며, ADA2 동종효소의 활성도 측정은 ADAl의 강력한 억제제인 EHNA(erythro-9-(2-hydroxy-3-nonyl) adenine)을 이용하여 측정하였다. 결 과: 결핵성 흉수에서의 총ADA 활성도는 악성 흉수보다 높았으나 (p<0.l), 결핵성 흉수와 부폐렴성 흉수사이에는 유의한 차이가 없었다(결핵성 흉수 : $148.9{\pm}89.9IU/L$, 부폐렴성 흉수 : $129.0{\pm}119.4IU/L$, 악성흉수 : $60.7{\pm}17.8%$). 흉수에서 총 ADA에 대한 ADA2 동종효소의 활성도의 비 (ADA2%)는 결핵성 흉수에서 부폐렴성 흉수에 비해 유의하게 놓았으나(p<0.05), 결핵성 흉수와 악성 흉수 사이에는 유의한 차이가 없었다(결핵성 흉수: $57.2{\pm}10.7%$, 부폐렴성 흉수 : $35.9{\pm}17.8%$, 악성 흉수 : $60.7{\pm}17.8%$). 소방형 흉수의 경우 총 ADA 활성도는 결핵성흉수와 부폐렴성 흉수 사이에 유의한 차이가 없었으나(결핵성 흉수 : $157.8{\pm}100.8$ IU/L, 부폐렴성 흉수 : $164.3{\pm}132.3$ IU/L), ADA2% 는 결핵성 흉수에서 부폐렴성 흉수보다 유의하게 높았다(p<0.005)(결핵성 흉수 : $53.3{\pm}3.9%$, 부폐렴성 흉수 : $27.8{\pm}7.9%$). 결 론: 흉수에서 ADA동종효소의 측정은 결핵성 흉수와 부폐렴성 흉수의 감별진단에 유용하며 특히 소방형 흉수의 경우와 같이 임상적으로 강별이 용이치 않은 경우에 더욱 유용할 것으로 생각된다

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.67-73
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• 2021

Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (P_EL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid. Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of P_EL after the aspiration of 500 mL of fluid was done with "P_EL 0.5" (cm H₂O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The P_EL values were compared with pleurodesis outcomes. Results: After 4-week of follow-up, the success rate of pleurodesis was 65%. The P_EL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of P_EL 0.5 >14.5 cm H₂O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001). Conclusion: P_EL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.

• 한국임상수의학회지
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• 제18권2호
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• pp.167-169
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• 2001

A 10-year-old castrated male Siba dog was presented for signs referable to pleural effusion associated with neoplasm of the thoracic cavity. The pleural effusion fluid consisted of blood and tumor cells by thoracocentesis. Histopathological examination of the sedimentary tumor cells revealed malignant mesothelioma. Intracavitary carboplatin was administered at 300 mg/$m^2$ every 5 weeks for 3 treatment and pleural effusion was disappeared after 3 treatments. The dog had recurrence of pleural effusion at 515 days but intracavitary carboplatin chemotherapy had no effect. It would be thought that the intracavitary carboplatin treatment was quite a useful method to control a canine malignant mesothelioma with minimal toxicity.

• 대한한방내과학회지
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• 제35권3호
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• pp.366-372
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• 2014

Objectives: This is a report of a case of a stage IV non-small-cell lung cancer (NSCLC) patient whose malignant pleural effusion & respiratory symptoms have been relieved with Korean medicinal prescription, modified Yieum-jeon. Methods: A 56-year-old male diagnosed with stage IV NSCLC suffering malignant pleural effusion with complaints of cough, sputum, bilateral leg edema, dysphagia, post neck and left scapular pain was treated with modified Yieum-jeon and acupuncture during 16days. After treatment, blood lab and chest X-ray were used to follow the condition of malignant pleural effusion & pulmonary symptoms. Results: Malignant pleural effusion and pulmonary symptoms were improved with modified Yieum-jeon intake without any related adverse side effects. Conclusions: This study suggests Yieum-jeon may play a positive role in improving the malignant pleural effusion symptoms in advanced lung cancer cases.

• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.289-291
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• 2004

Malignant melanoma develops from melanocytes and frequently metastases to other organs. Common metastatic sites are other skin, lymph nodes, lung, liver, brain and bone in decreasing order of frequency. Malignant pleural effusion is less frequent manifestation of thoracic metastasis. We experienced a 57-year-old man with pleural effusion who received radical resection with local flap on left foot due to acral lentiginous melanoma 3 years ago. He had progressive chest pain and left massive pleural effusion. The pleural cytology and biopsy showed malignant melanoma. After closed thoracostomy and talc pleurodesis, he refused further immunotherapy and chemotherapy and discharged.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2611-2614
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• 2013

Aims: To explore efficacy and side effects of intrapleural or intraperitoneal lobaplatin for treating patients with malignant pleural or peritoneal effusions. Methods: Patients in Jiangsu Cancer Hospital and Research Institute with cytologically confirmed solid tumors complicated with malignant pleural effusion or ascites were enrolled into this study. Lobaplatin (20-30 $mg/m^2$) was intrapleurally or intraperitoneally infused for patients with malignant pleural effusion or ascites. Results: From 2012 to 2013, intrapleural or intraperitonea lobaplatin was administered for patients with colorectal or uterus cancer who were previous treated for malignant pleural effusion or ascites. Partial response was achieved for them. Main side effects were nausea/vomiting, and bone marrow suppression. No treatment related deaths occurred. Conclusion: Intrapleural or intraperitoneal infusion of lobaplatin is a safe treatment for patients with malignant pleural effusion or ascites, and the treatment efficacy is encouraging.

• 대한한의학회지
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• 제32권6호
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• pp.117-121
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• 2011

Objectives: We report one patient with pleural effusion and effusion-related symptoms in small cell lung cancer (SCLC) successfully treated with Gunreyngtang-gagambang. Methods: Gunreyngtang-gagambang was administered at 30 minutes after mealtime, three times a day, for two months. Except for herbal medicine, the patient did not take any treatment including pharmaceutical or non pharmaceutical for effusion. Result: Two months later, the symptoms and the pleural effusion had disappeared from chest X-ray. Conclusion: Gunreyngtang-gagambang was effective for treatment of malignant pleural effusion due to small cell lung cancer.