• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.564-573
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• 1999

Background: With variable symptoms and nonspecific radiographic appearances, pulmonary embolism (PE) is a frequent and often undiagnosed cause of mortality and morbidity. The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study suggested that the majority of patients undergoing ventilation-perfusion (V-Q) scan would require additional studies to establish or to exclude the diagnosis of PE. Pulmonary angiography has been regarded as gold standard for diagnosis of PE. However, it is an invasive procedure that may be associated with significant notable morbidity and mortality. Thus, availability of an accurate, noninvasive screening examination is highly desirable. Method: From October 1994 to February 1997, twenty patients (male 13, female 7, range 23-91 years, median 58 years) who were suspected as pulmonary embolism on the basis of clinical evidence and underwent the spiral volumetric computed tomography (spiral CT), were studied retrospectively to evaluate the effectiveness of spiral CT as a diagnostic tool in PE. Results: PE could be excluded with spiral CT in 4 patients ; diagnoses of these patients were lung cancer, pneumonia with lung abscess, bilateral pleural effusion due to congestive heart failure, nonspecific pulmonary abnormality retrospectively. One patient who disclosed high probability in V/Q scan, could be diagnosed as pneumonia with lung abscess and underlying emphysema with spiral CT. Among 4 patients who showed intermediate and low probability in V/Q scan, 3 patients could be confirmed as PE with spiral CT. Spiral CT was helpful in 3 patients, in whom V/Q scan could not be performed due to other reasons (e.g. night time, mechanical ventilation) to confirm the diagnosis of PE. Spiral CT could demonstrate embolus above lobar artery level in 11 patients, and up to segmental artery level in 5 patients. Conclusion: This study demonstrated that spiral CT could allow accurate demonstration of thrombotic clots in centrally localized embolism. Spiral CT could be effective, specific, noninvasive and useful diagnostic screening modality for the diagnosis of pulmonary embolism.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.767-774
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• 1999

Background : Tuberculous mediastinal lymphadenitis (TML) is a relatively commonly encountered in Korea. However, there were no datas available on TML without other combined tuberculous infections in Korea. We retrospectively analyzed clinical manifestations, radiologic findings, Chest CT scan findings, the duration of treatment, and follow up Chest CT scan findings of 23 cases who had only TML. Method : 23 cases from 1991 to 1997 with TML confirmed by biopsy and had no other combined tuberculous infections were studied retrospectively. Results : Of the 23 cases, 7 cases were male and 16 female. The male to female ratio was 1 : 2.4. Mean age was 31 years and the most prevalent age group was the 3rd decade(43%). The most common presenting symptoms were fever(39%) followed by no symptom, cough, swallowing difficulty, and chest discomfort. On simple chest X-ray, mediastinal enlargement were noted in 20 cases(90%). The most frequently involved site was the paratracheal node in 11 cases with the right to left side involvement ratio being 4.6 : 1. On chest CT scan, the most commonly enlarged node was the paratracheal node(33%) followed by the subcarinal(20%), hilar(13%), tracheobronchial (8%), subaortic(8%), supraclavicular(8%) and anterior. mediastinal nodes. 6 cases were dropt out due to incomplete follow up. Thirteen cases were treated with HERZ regimen and the mean duration of treatment was 14 months. Three cases were treated with second line drug regimens(Tarivid, Pyrazinamide, Streptomycin plus Ethambutol or Para-aminosalicylic acid) for 18 months. In HERZ groups, one case was recurred after 10 months later and retreatment was done by same HERZ regimen during 12 months. Follow up chest CT scan after completion of treatment were done in 13 cases and that revealed more than a 50% decrease in size in 77% of the cases and no interval change in 23% of the cases. Conclusion : In cases of TML without other combined tuberculous infection, the minimal duration of treatment was required 12 months by HERZ regimen and 18 months by a 2nd line regimen or more. Further studies will be needed to confirm the treatment duration for TML without other combined tuberculous infections.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.560-569
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• 2003

Background : A large number of pollutants such as sulfur dioxide, nitric oxide, carbon monoxide, particulate matter, and ozone influence on the body. These pollutants put a burden on the lung and the sequelae resulting from the oxidative stress are thought to contribute to the development of fibrotic lung disease, emphysema, chronic bronchitis and lung cancer. Also, carbon monoxide generated from the incomplete combustion of carbon-containing compounds is an important component of air pollution caused by traffic exhaust fumes and has the toxic effect of tissue hypoxia and produce various systemic and neurologic complications. The objective of this study is to compare the difference of pulmonary function and serum carboxyhemoglobin(CO-Hb) level between the traffic policemen and clerk policemen. Method : Three hundred and twenty-nine of traffic policemen, and one hundred and thirty clerk policemen were included between 2001 May and 2002 August. The policemen who took part in this study were asked to fill out a questionnaire which included questions on age, smoking, drinking, years of working, work-related symptoms and past medical history. The serum CO-Hb level was measured by using carboxyoximeter. Pulmonary function test was done by using automated spirometer. Additional tests, such as elecrocardiogram, urinalysis, chest radiography, blood chemistry, and CBC, were also done. Results : $FEV_1(%)$ was $97.1{\pm}0.85%$, and $105.7{\pm}1.21%$(p<0.05). FVC(%) was $94.6{\pm}0.67%$, and $102.1{\pm}1.09%$, respectively(p<0.05). Serum CO-Hb level was $2.4{\pm}0.06%$, and $1.8{\pm}0.08%$(p<0.05). After correction of confounding factors (age, smoking), significant variables were FVC(%), $FEV_1(%)$ and serum CO-Hb level(%)(p<0.05). Conclusion : Long exposure to air pollution may influence the pulmonary function and serum CO-Hb level. But, further prospective cohort study will be needed to elucidate detailed influences of specific pollutants on pulmonary function and serum carboxyhemoglobin level.

• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.386-394
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• 2003

Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.72-75
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• 2006

Background : This report reviews our experience with persistent air leaks in the peumothorax that were not considered candidates for surgical treatment in order to evaluate the efficacy and risks of the OK-432 plus autoblood or OK-432 pleurodesis. Material & Methods : From March 2004 to July 2005, 8 consecutive patients who had an air leak in the pneumothorax over 5 days and had been treated with OK-432 plus autoblood or OK-432 pleurodesis. The patients were not considered candidates for surgical treatments because the chest CT findings revealed severe chronic lung disease with multiple bullae and/or bullous changes. A prolonged air leak with/without dead space was treated with either OK-432 plus autoblood or OK-432 pleurodesis. The efficacy and side effects of OK-432 pleurodesis were assessed by determining the duration of the air leak, the number of pleurodesis, the patients' symptoms, measurements of the white blood cell count and the c-reactive protein level. Results : All of eight patients were male and the mean age was $72.4{\pm}8.5$. The mean number of pleurodesis was $1.9{\pm}1.1$ and the mean duration of the air leak was $4.6{\pm}4.6days$ after pleurodesis. Side effects after pleurodesis were encountered in 7 patients, which included a chilling sensation in 7 cases, chest pain in 5 cases, headache in 3 cases, local heat sensation in 2 cases, and fever in 1 case. Leukocytosis was observed in 6 patients, and the mean of WBC count and CRP were $14500{\pm}2100$ and $21.9{\pm}11.4mg/dL$, respectively. Conclusion : Either OK-432 plus autoblood or OK-432 pleurodesis has acceptable side effects, and can be considered a treatment option for persistent air leaks in the pneumothorax that are not candidates for surgical treatment.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.473-479
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• 2005

Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.104-113
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• 2003

Background : Rhinovirus(RV) infections frequently trigger dyspnea and paroxysmal cough in adult patients with asthma and are the most prevalent cause of the common cold. However, the mechanisms of a RV-induced airway inflammation is unclear. Since the RV does not directly destroy the airway epithelium, it is presumed that the immune response to the RV contributes to the pathogenesis of the respiratory symptoms. In order to test this hypothesis, this study characterized the time-sequenced alterations in interleukin(IL)-8 elaboration from the human bronchial epithelial cells and evaluated the role of NF(nuclear factor)-${\kappa}B$ in the RV-induced IL-8 production by pretreating the inhibitors of NF-${\kappa}B$ activation. Methods : The ability of RV-infected human bronchial epithelial cells and BEAS-2B cells to produce the IL-8 was compared with the controls. This study infected BEAS-2B cells with the RV14 obtained from the American Type Culture Collection. The supernatants were harvested from the RV infected BEAS-2B cells and the controls at 2hr, 4hr, 6hr, 12hr, 24hr, 48hr from the inoculation time. This study measured the IL-8 concentration using the ELISA kits. In order to elucidate the role of NF-${\kappa}B$ in the RV-induced IL-8 production, the effect of the NF-${\kappa}B$ inhibitors was evaluated on RV-induced IL-8 production. Results: The BEAS-2B cells produced small amounts of IL-8 that accumulated slowly with time in the culture. The RV was a potent stimulator of the IL-8 proteins production by BEAS-2B human bronchial epithelial cells. Antioxidants, N-acetyl-L-cysteine(NAC),\ and pyrrolidine dithiocarbamate(PDTC), blocked the IL-8 elaboration by the RV-infected BEAS-2B cells, which was dose-dependent, but N-Tosyl-L-phenylalanine chloromethyl ketone(TPCK) did not. Conclusion: Some antioxidants inhibited the RV-induced IL-8 production by blocking the NF-${\kappa}B$, which may have a therapeutic potential in asthma.

• Tuberculosis and Respiratory Diseases
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• v.63 no.6
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• pp.486-490
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• 2007

Background: This study examined the effect of corticosteroids as a short-term treatment for patients with hemoptysis that requires conservative treatment including bed rest, antitussives and antibiotics. Methods: From February 2005 to August 2006, 78 consecutive patients who visited the emergency room because of hemoptysis were enrolled in the study. Patients with hemoptysis due to lung cancer, active pulmonary tuberculosis, and pneumonia were excluded. The 78 patients were divided randomly into a corticosteroid medication group (n=37) and a control group (n=41). The mean control time of hemoptysis, mean in-hospital days, and complications of treatment were investigated prospectively. Results: For the etiology of hemoptysis, inactive pulmonary tuberculosis alone or its associated complications (bronchiectasis and/or aspergilloma) were the most common causes (51%); bronchiectasis alone and bronchitis were the next most common causative diseases (15%, respectively). The patients' characteristics and symptoms in the corticosteroid medication and control groups were similar. The steroid medication group showed a significantly lower mean control time of hemoptysis than the control group ($4.0{\pm}2.7$ days, $6.1{\pm}4.8$ days, respectively) (p=0.022) and had a lower mean number of in-hospital days ($5.8{\pm}3.4$ days, $7.9{\pm}4.8$ days, respectively) (p=0.036). There were no significant complications, such as hospital-acquired pneumonia or gastrointestinal bleeding, related to the use of corticosteroids. Conclusion: The use of corticosteroids as a conservative treatment for hemoptysis due to bronchitis, bronchiectasis, inactive pulmonary tuberculosis and its related complications safely reduces the control time of hemoptysis as well as the number of in-hospital days.

• Microbiology and Biotechnology Letters
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• v.38 no.1
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• pp.53-63
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• 2010

As one of the mucous components of Cheonggukjang, traditional fermented soybean paste, $\gamma$-PGA is a natural substance with diverse functions. In this paper, an in-vivo experiment has been performed using NC/Nga mice in order to find out the efficacy of $\gamma$-PGA in human atopic dermatitis. The NC/Nga mice with BMAC-induced atopic dermatitis were administered $\gamma$-PGA (PGA-HM) with 300 kDa and low-molecular $\gamma$-PGA (PGA-LM), respectively. As a result, a significant decrease in clinical skin severity score was detected in the group that was administered PGA-LM. In terms of serum IgE levels, a significant decline was observed in PGA-LM, compared to the control group. The serum IgG1 levels also decreased more in PGA-LM than in the control group. However, no significant difference was observed in both groups. To witness the induction of $CD4^+CD25^+foxp3^+$ Treg cells, mRNA was sampled from the back of PGA-HM- and PGA-LM-administered NC/Nga mice with atopic dermatitis. In terms of the production amount of foxp3 mRNA, which was measured in real-time PCR, the group that was administered PGA-LM was twice as high as the control group. According to a biopsy on the skin on the backs of the mice, the experimental group was also far lower than the control group in terms of epidermis thickness, mast cell infiltration and the number of $CCR3^+$ cells. Therefore, it has been confirmed that the atopic dermatitis symptoms decreased more in the PGA-LM-administered NC/Nga mice than the PGA-HM-administered group by facilitating $CD4^+CD25^+foxp3^+$ Treg cells and suppressing the activity of eosinophils and production of IgE and pro-inflammatory cytokines.

• The Journal of Korean Physical Therapy
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• v.8 no.1
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• pp.21-32
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• 1996

This study was conducted in an attempt to grasp the health problems and environmental situation of the farmers and their vinyl houses. The study was done between Aug. 10, 1995 and Sep. 10, 1995, for one month period. with two hundred and nine vinyl house cultivation farmers chosen at random as subjects in five areas in and around Kim Chun City. The following are the results of the study carried out through direct interviews and surveys with the subjects : 1. The career of farming on vinyl house facilities by sex(male vs female) averages 17.29 and 15.08 years is shorter than that of general farmer's average of 31.24 and 25.58 years(P<0.05). Hours of labor between the two are silimar : monthly labor hours for vinyl house farmers are average 28 and 27.52 days. longer than the general farmers' average of 26.57 and 25.95 hours respectively. 2. The comp aints of physical symptoms among the vinyl house farmers range from lumbago, shoulder pain dullness in the limbs and dizziness, which show no remarkable differences from those of general farmers. 3. The frequency of application of chemicals on vinyl house forming for a period of one year averages 23.79, three times as often as the general farmer's average or 8.36(P<0.05). In the addiction rate of chemicals, too, the vinyl house farmer stowed a higher percentage of $9.09\%$ over the general farmer's $1.24\%$(P<0.01). 4. In temperature, humidity and disconfort indices of in and outside of the vinyl house, room temperature is on an average $34.6{\pm}5.05^{\circ}C,\;11.7^{\circ}C$ higher than that of outside, while in humidity inside was lower than outside by $10.6\%$ point, $65.9\%$ over $76.5\%$. The discomfort index was higher inside by $83{\pm}4.61\;vs\;70.64{\pm}5.61$. 5. The status of physical treatment over the past one year shows : for vinyl house farmers-physiotheraphy$(43.06\%)$, pharmacy$(24.04\%)$, clinic(18.66%), herbal medicine(574%) : for general farmers-pharmacy$(34.16\%)$, Physiotherapy$(27.33\%)$, Clinic$(18.63\%)$, Folk Medicine$(11.18\%)$ (P<0.01).