• Title/Summary/Keyword: 기관지천식

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A Study on Changes in Blood Eosinophil, Serum IgE and T Lympocyte Subpopulation after Sochongryongtang to Asthmatic Patients (소청룡탕치료 기관지천식환자의 혈액내 호산구수와 혈청IgE 및 T림프구아형의 변화)

  • Jung, Hee-Jae;Ju, Chang-Yeop;Lee, Jae-Sung;Lee, Kyung-Ki;Rhee, Hyung-Koo;Jung, Sung-Ki;Hwang, Woo-Suck
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.83-89
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    • 2002
  • Background : Nowadays asthma is considered to be an inflamatory disease characterized by airborne hyper-responsiveness and pulmonary eosinophilia. Objective : We aimed to identify the effects of Sochongryongtang on blood eosinophil, serum IgE and T lympocyte subpopulation in asthmatic patients. Material and Methods : The subjects consisted of fifteen patients with asthma who had been treated with Sochongryongtang for two weeks from February 2001 through June 2001. Sochongryongtang is herbal decoction which has been used for the traditional therapeutic agent of asthma. Results : The blood eosinophil and serum IgE in a normal controlled group. However, the T lympocyte subpopulation in asthmatic patients was not significantly different from the T lympocyte subpopulation in a normal group. The patients were treated with Sochongryongtang for two weeks. No significant difference in the blood eosinophil, serum IgE and T Iympocyte in the sub population. After treatment with Sochongryongtang for two weeks, FEV 1 increased significantly over 0.5 points out of total scores. Conclusion : This study shows that Sochongryongtang has effects on improvement of pulmonary function and quality of life in asthmatic patients. However, the patients who were treated with Sochongryongtang for two weeks showed no significant difference in the blood eosinophil, serum IgE and T lympocyte subpopulation. Further long-term studies must be made on a large number of asthmatic patients.

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The Steroid Sparing Effects of Cheongsangboha-tang in Asthmatic Patients (청상보하탕(淸上補下湯)의 기관지천식환자에 대한 스테로이드 절약효과)

  • Choi Jun-Yong;Lee Jae-Sung;Ju Chang-Yeop;Jung Hee-Jae;Rhee Hyung-Koo;Jung Sung-Ki;Hwang Woo-Suck
    • The Journal of Internal Korean Medicine
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    • v.24 no.1
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    • pp.1-10
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    • 2003
  • Background : In recent years, the glucocorticoid hormone has become a fundamental medication for asthma. However, a long period of hormone administration will result. in general. side effects on many body parts as well as hormone dependence, which has become a serious problem for western physicians. Objectives : We aimed to identify the clinical effects of Cheongsanghoha-tang and the steroid sparing effects of Cheongsanghoha-tang on. Materials and Methods : A subject group consists of 36 asthmatics who had been treated with Cheongsanghoha-tang for four weeks. Cheongsanghoha-tang is a herbal decoction, which has been used of the traditional therapeutic agent of asthma. PFT, QLQAKA, blood eosinophil, serum IgE, Serum IL-4. IL-5, IFN-${\gamma}$ were checked before and 4weeks after the treatment. Results : The only FVC% in ICSG among asthmatic patients was increased significantly compared to NICSG. Treatment of Cheongsanghoha-tang for four weeks resulted in significant increase in QLQAKA. The NICSG treated with Cheongsangboha-tang for four weeks were no significant difference in the blood eosinophil, serum IgE, IL-4 and IL-5. The PFT and QLQAKA in NICSG were increased significantly after 4 weeks treatment. But the serum IFN-${\gamma}$ in NICSG was decreased significantly after 4 weeks treatment. Discontinuation of treatment with inhaled corticosteroid in ICSG resulted in insignificant changes in PFT, the blood eosinophil, the serum IgE, IL-4, IL-5 and IFN-${\gamma}$ and significant increase in QLQAKA. As a result. 8 of 13 cases were cured with hormones completely and the rest of ICSG reduced the dose of ICS. Conclusions : This study shows that Cheongsanghoha-tang has the effects on the improvement of pulmonary function and cures asthmatic patients. These findings demonstrate that Cheongsanghoha-tang has the steroid sparing effect. Some satisfactory therapeutic results have been obtained in treating hormone-dependent asthma by Cheongsanghoha-tang. However. the concept and mechanism of hormone-dependent asthma have not been fully defined yet, and the standard for judging therapeutic effects have not been established. Obviously further researches concerning all these are still necessary.

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Radioaerosol Inhalation Imaging in Bronchial Asthma (기관지 천식의 연무흡입 폐환기스캔 소견)

  • Kim, Bum-Soo;Park, Young-Ha;Park, Jeong-Mi;Chung, Myung-Hee;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.46-52
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    • 1991
  • Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a BARC(Bhabha Atomic Reserch Center, India) nebulizer with 15 mCi of $^{99m}Tc-phytate$. The scanning was peformed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with $^{99m}Tc-MAA$. Follow-up scans were obtained in 5 patients after bronchodilator therapy. The patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of basal interstitial markings in 26 of the 31 patients. Chest radiographs were norma! in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present in 17 patients. The abnormality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abnormality and the effect of treatment with bronchodilators in patients with bronchial asthma.

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Association Study of Glutathione-S-Transferase M1/T1 Gene Polymorphism with Deficiency-Excess Differentiation-syndrome in Korean Bronchial Asthmatics (한국인 기관지 천식 환자에서 허설변증과 Glutathione-S-Transferase 유전자의 다형성 연구)

  • Yu, Seung-Ryeol;Jeong, Seung-Yeon;Jung, Ju-Ho;Kim, Jin-Ju;Jung, Sung-Ki
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.453-463
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    • 2007
  • Backgrounds : Glutathione-s-transferase (GST) is a kind of phase II metabolism enzyme and plays an important role in the detoxification of various toxic chemicals. It was reported that the genetic polymorphism of GSTM1 and GSTT1 genes may be responsible for asthma development and susceptibility to allergy. Traditional oriental medicine uses a unique diagnostic technique. differentiation-syndrome. to analyze signs and symptoms of patients synthetically. Through differentiation-syndrome. asthma patients can be divided into two groups: the deficiency syndrome group (DSG) and the excess syndrome group (ESG). Objectives : The purpose of this study was to investigate the possible association of GST gene polymorphism with clinical phenotype by differentiation-syndrome of bronchial asthma patients. Materials and Methods : One hundred and ten participants were evaluated by pulmonary function test. Patients with 53 DSG and 31 ESG by differentiation-syndrome were assessed for genetic analysis. GSTM1 and GSTT1 deletion polymorphism was performed by polymerase chain reaction (PCR). Results : GSTM1 gene deletion was detected in 43.4% of individuals in the DSG and in 38.71 % in the ESG. The distribution of GSTM1 polymorphism between DSG and ESG was not significantly different [$x^2$=0.1767, p=0.6742; OR(95% CI)=1.2139(0.4915-2.9979)]. The proportion of GSTT1 null genotypes was 41.51% in the DGS and 45.16% in the ESG. The distribution of GSTT1 polymorphism between DSG and ESG was also not significantly different [$x^2$=0.1065, p=0.7442; OR(95% CI)=0.8618(0.3525-2.1065)]. In the combined analysis of GSTM1 and GSTT1 genes, the frequency of both null type of GSTM1/GSTT1 genes was not significantly different from both positive type of GSTM1/GSTT1 genes[$x^2$=0.0768, p=0.7817; OR(95% CI)=1.2000(0.3303-4.3602)] Conclusions : These results indicate that polymorphism of the GST gene might not be associated with the symptomatic classification of DSG and ESG by differentiation-syndrome in Korean asthmatics.

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Development of Model Linking Pilot System (WaterRing) for IWRM (통합수자원 모델 연계 파일럿 시스템 (WaterRing) 개발)

  • Lee, Sung-Hack;Kim, Sung;Kang, Jae-Won;Lee, Mi-Yeon
    • Proceedings of the Korea Water Resources Association Conference
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    • 2007.05a
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    • pp.2024-2028
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    • 2007
  • 우리나라의 물관련 이슈는 수자원뿐만 아니라 사회, 경제 환경 등의 범위까지 확대되어 복합적이며, 기존 방법론과 기술만으로는 해결에 어려움이 있다. 따라서 새로운 기술적/방법론적 도구 개발의 필요성에 따라 통합수자원관리가 하나의 방법으로 받아들여지고 있다. 통합수자원관리는 지속가능한 수자원관리를 목표로하며, 물과 이와 관련 다양한 요소를 고려하는 통합적인 방법론이다. 그러므로 의사결정에 있어 전체론적인 접근이 필요하며, 세부적인 요소와 요소간의 연관관계를 파악하는 것이 중요하다. 이를 위하여 본 연구에서는 통합수자원관리의 기반 도구 중의 하나인 통합수자원관리 모델링 환경인 WaterRing 시범시스템을 개발하였다. WaterRing은 모델연계에 있어 필수적인 표준성, 사용편의성 및 모델공유를 제공하며, 모델코드 자체보다 모델의 개발에 많은 노력을 기울일 수 있도록 설계되었다. 따라서 수자원분야 및 다양한 분야의 모델을 연계할 수 있다. 모델의 연계를 위하여 기본모델단위를 설정하고 각각의 기본모델단위의 결합을 통하여 보다 큰 시스템으로 구성할 수 있도록 하였다. 기본모델단위는 입력/상태/출력의 세 가지 기본요소와 내부수행 루틴으로 구성되어 있다. 기본모델단위 사이의 결합을 정의하기 위하여 BPM(Business Process Management)(Arkin, 2002)와 STELLA의 모델 결합방식을 활용하였다. 기본모델단위는 독립적인 수행단위로 표준적인 입력과 출력을 수행한다. 따라서 입력과 출력의 속성이 같은 기본모델단위는 결합할 수 있다. 본 연구에서 시범적으로 개발된 수자원통합모델링환경 WaterRing은 통합수자원관리의 실현에 있어 평가, 계획에 이용될 수 있다. 그러므로 향후 시스템의 개발이 완료되면 우리나라의 통합수자원관리의 실현을 위한 기반도구로서 많은 역할이 기대된다. 홍수기에 측정된 성과를 바탕으로 고수위대의 수위-유량관계 곡선식을 개발하여야 할 것으로 판단된다. 본 연구를 통해 일부 확인된 바와 같이, 일반적인 자연하천이 아닌 감조하천의 경우는, 각각의 수위대별 유량 값의 변화가 발생하는 바 기간별 혹은 간조와 만조부를 포함하여 유량측정을 하여야 할 것으로 판단된다. 청폐화담탕(淸肺化痰湯)은 LPS로 유도된 macrophage에서 NO와 염증Cytokine 생성량을 억제하였고 murine macrophage에서 NF-${\kappa}$B 활성을 억제함으로써 iNOS와 염증Cytokine 유전자 발현을 하향조절 하였다. 이러한 청폐화담탕(淸肺化痰湯)의 항염작용으로 천식, 기관지염, 폐렴, 결핵, 산후감모 등의 호흡기 질환에 응용할 수 있으리라 사료된다.im}$5개월), 9.44${\pm}$1.05 6${\sim}$ll개월)으로 개월에 관계없이 전반적으로 유사한 비율을 나타내었다. 분획물(첨가농도 15.6 ${\mu}$g/ml)은 60%의 저해효과를 나타내면서 농도 의존적으로 그 저해효과가 컸으며 250 ${\mu}$g/ml 농도에서는 80%의 저해효과를 관찰 할 수가 있었다. 에틸아세테이트분회물의 경우 디글로로메탄 분회물에 비해 다소 낮은 저해효과를 나타내었지만 250 ${\mu}$g/ml 농도에서 약 60%의 세포독성 효과를 나타내었다. 디클로로메탄 분획물과 에틸아세테이트 분획물에 의한 면역 활성 증진 효과를 검토한 결과, 디글로로메탄 분획물은 첨가농도 1 ${\mu}$g/ml에서 94%로 Yac-1표적세포를 사멸시켰으며 에틸아세테이트 분획물도 동일 농도에서 96%의 억제효과를 나타내었다. CTLL세포를 이용

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A clinical Study on Pediatric Bronchoarthma (II) (소아기관지(小兒氣管支) 천식(喘息)의 임상적(臨床的) 고찰(考察 ) (제(第)II보(報)))

  • Jeong Gyu-Mann;Kim Deog-Gon;Lee Dong-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.1 no.1
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    • pp.79-89
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    • 1986
  • During 34 months from October 1982 to July 1985, a clinical study was made on 217 cases of out-patients with pediatric bronchoarthma at Kyung-Hee University Oriental Hospital. ?The observed results were as follows; ?1. In the age of the patients ranged from six months to twelve years; they were almost under six years (73.1 %) The ratio of male to female was 3: 1. ?2. In case of the age to be attacked with bronchoarthma, the age 3 covered 43.9% (95 cases), and the ages of less than 6 years 86.3% (187 cases); and, especially, the age 2 - 3 covered the highest rate (18.4%; 40 cases) ?3. The contraction period of bronchoarthma was almost less than one year (70.1%; 152 cases); especially, less than one week covered the highest rate (22.1 %; 48 cases) ?4. In case of the contraction season; winter (December to February) had the highest rate (33.2%; 72 cases), and fall, spring and summer came after it. And 13 cases (6%) were attacked in all seasons. ?5. Of a day, the severe symptom was shown most frequently from 6 pm to midnight (31.3%; 68 cases), and next from midnight to 6 am (29.1%; 62 cases) ?6. The common symptoms of out-patients were productive cough (24.0%; 147 cases), easily-catch-cold (22.5%; 138 cases), dry cough (11.4%; 70 cases), and so on. ?7. In case of the history of the patients, upper respiratory infections covered 52.1 % (113 cases) bronchitis(29.0%; 63 cases), pneumonia(17.1%; 37 cases), and tonsilitis& pharyngitis(6.0%; ?13 cases): and allergic symptoms covered (42 cases: 19.3%) fetal fever & eczema (11.5%: 25 cases), and allergie Rhinitis (7.8%: 17 cases) ?8. The family of the patients were shown to have the history of bronchitis (21.6%; 47 cases), bronchoarthma (21.2%; 46 cases), and tuberculosis (16.6%; 36 cases) ?9. The factors of bronchoarthma were shown as upper respiratory infections (38.3%; 38 cases), cold weather (18.9%; 41 cases), and exercise (175%; 38 cases) ?10. Of the treatment periods of the patients, less than one month (69.2%; 150 cases) took the highest rate, in which less than a week was 33.2% (72 cases) and one or two weeks 15.2% (33 cases) ?11. The main prescriptions were kunpyunetang (79 cases; 17.0%), Agoayangyuegunpyuetang (73 cases; 15.7%) and Haepyoyangjintang (72 cases; 15.6%) ?12. In the results of treatment, 132 cases (60.9%) was improved; especially, subjective signs of 33 cases (15.2%) of them, was almost removed.

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The Association of Obesity, Airway Hyperresponsiveness and Atopy in Chronic Cough Patients: Results of a Two-Center Study (만성 기침환자에서 기관지 과민성, 아토피와 비만의 상관관계: 두 기관 연구)

  • Park, So-Yong;Park, Jong-Won;Oh, Yeon-Mok;Rhee, Yang-Keun;Lee, Young-Mok;Park, Yong-Bum;Lim, Seong-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.24-29
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    • 2011
  • Background: The rising prevalence of asthma worldwide may be associated with the rising prevalence of obesity in developed nations. Although several studies have suggested a relationship between asthma and obesity, controversy still remains. The aim of this study was to examine the relationship between obesity and asthmatic factors such as atopy, eosinophilia, serum total Ig E and bronchial hyperresponsiveness in chronic cough patients. Methods: This study was a retrospective, observational study in two centers done between January 2007 and June 2008. The subjects included individuals who had a chronic cough. We examined body mass index (BMI) to measure obesity and pulmonary function. We did a metacholine provocation test for airway hyperresponsiveness (AHR), a skin prick test for atopy, and tests for blood eosinophils and serum IgE. Results: A total of 1022 subjects were included. Airway hyperresponsiveness was not related with obesity (p=0.06), and atopy incidence was significant higher in non obese patients (p=0.00). There was no significant difference in serum IgE and blood eosinophil counts between obese and non obese patients. Forced expiratory volue in one second ($FEV_1$)/forced vital capacity (FVC) was significantly reduced in obese patients (p=0.03), but FEV1 and FVC were no significant difference between obese and non obese patients. Conclusion: There is no relationship between obesity and bronchial hyperresponsiveness. The nonobese group appears to have more atopy. The relationship between obesity and bronchial hyperresponsiveness and atopy need further investigation.

Change of Bronchial Permeability in Patients with Bronchial Asthma (기관지 천식환자에서 기도 투과성에 관한 연구)

  • Hwang, Jeong-Sil;Kim, Sin-Ae;Kwack, Jun-Gu;Park, Myung-Jae;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hun;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.164-171
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    • 1991
  • To evaluate the effect of damaged bronchial epithelium on epithelial permeability and physiologic changes of the airway in patients with bronchial asthma, we measured the concentration of protein and albumin in bronchoalveolar lavage fluid (BALF), the width of intercellular junction and bronchial hyperreactivity in 22 patients with bronchial asthma and 21 healthy subjects. The results were as follows: 1) The concentration of protein in BALF from patients with bronchial asthma was higher when compared with that of normal subjects ($237{\pm}182$ vs $113{\pm}78\;{\mu}g/mL$, p<0.05), and the concentration of albumin was also higher than that of normal subjects ($116{\pm}126$ vs $32{\pm}88\;{\mu}g/mL$, p<0.05). The ratio of the concentration of protein in BALF to that in serum was increased in patients with bronchial asthma when compared with that of normal subjects ($0.35{\pm}0.30$ vs $0.16{\pm}0.11%$, p<0.05). 2) The intercellular junction of bronchial epithelium was widened in 14 of 20 patients with bronchial asthma, in contrast, 5 of 14 normal subjects (p<0.05). The mean width of intercellular junction was greater when compared with that of normal subjects ($1.71{\pm}1.81$ vs $0.56{\pm}0.85\;{\mu}m$, p<0.05). The width was well correlated with the ratio of protein in BALF to that of serum (r=0.3226, p=0.047) when observed in 18 patients with bronchial asthma and 10 patients with normal subjects. 3) The bronchial hyperreactivity, expressed as $PC_{20}$, was inversely correlated with the concentration of protein in BALF (r=-0.3030, p=0.038) in when observed in 18 patients with bronchial asthma and 19 normal subjects. 4) The width of intercellular junction was well inversely correlated with $PC_{20}$ (r=-0.5006, p=0.002) when observed in 19 patients with bronchial asthma and 11 patients with normal subjects. In conclusion, increased permeability and the damage of bronchial epithelium may lead to change of bronchial hyperreactivity.

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CLINICAL STUDY OF POLYPOID VOCAL CORDS (REINKE'S EDEMA) (폴립양 성대의 임상적 고찰)

  • 정광윤;최종욱;유홍균
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.32-32
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    • 1991
  • 성대의 점막하 조직의 부종을 특징으로 하는 폴립양 성대는 음성의 남용 및 상기도에 대한 다양한 자극 요인들에 의하여 발생된다고 보고되어 있으며, 현재까지 부종의 기전 및 병태에 대하여도 혈괴의 유리화 현상(hyalinization), 또는 단순한 혈관의 투과력 증대 등의 논란이 많은 실정에 있어 치료방법 역시 학자에 따라 견해를 달리하고 있다. 이에 저자들은 폴립양 성대의 치료에 도움을 얻고자 최근 5년간 본 교실에서 경험한 폴립양 성대 34례(남자 18예, 여자 16예, 평균연령 53.7세)에 대한 임상 소견 및 저자들의 치료 성적을 분석 검토하여 다음과 같은 결과를 얻었다. 1. 측별로는 총 34예중 양측 23예(67.6%), 편측 11예(32.4%)이었다. 2. 동반질환으로 성대에 타 질환이 있었던 예가 9예(후두용 5예, 과각화증 3예, 성대마비 1예 ; 26.5%), 수면무호흡증 5예(14.7 %)이었으며 전신질환이 있었던 예가 4예(기관지 천식 2예, 폐결핵 2예 ; 11.8%)이었다. 3. 유발요인으로는 음성남용 7예(20.6%), 상기도감염 3예(8.8%), 흡연 26 예 (76.5%)이었다. 4. 공기역학검사 및 청각심리검사가 가능하였던 14예에서 최대발성지속시간이 정상이하이었던 예가 10예(71.4%), 발성율이 정상이상이었던 예가 9예 (64.3%)이었으며, 애성의 특징도 조호성(rough)이 10예(71.4%)로 가장 많았다. 5. 총 34예를 sucking technique를 적용하여 수술적 치료를 하였는데 음성이 호전된 경우는 32예(정상 15예, 호전 17예 : 94.1%)이었으며 호전되는데 걸린 평균 기간은 2.8개월이었다. 이상의 성적으로 보아 폴립양 성대는 국소 또는 전신적으로 동반질환이 많고 흡연 등의 만성 자극 요인이 있으며 술후 음성 호전에 걸리는 기간이 길어 보다 복합적인 측면에서 치료에 임하여야 할 것으로 사료된다. with such configuration.trap with 2.88[eV] deep of injected space charge from the chathode in the crystaline regions. The origin of ${\alpha}$$_2$ peak was regarded as the detrapping process of ions trapped with 0.9[eV] deep originated from impurity-ion remained in the specimen during production process of the material, in the crystalline regions. The origin of ${\beta}$ peak was concluded to be due to the depolarization process of "C=0"dipole with the activation energy of 0.75[eV] in the amorphous regions. The origin of ${\gamma}$ peak was responsible to the process combined with the depolarization of "CH$_3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를

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The Management of Spontaneous Pneumothorax -Clinical Review in 451 Cases- (자연기흉의 임상적 고찰(451례))

  • 오태윤;장운하;배상일
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.374-379
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    • 1998
  • From March 1985 to June 1997, 451 patients of spontaneous pneumothorax treated at Kangbuk Samsung Hospital were reviewed retrospectively. Most of the patients were male (male to female ratio, 8.2:1). The mean age of the primary spontaneous pneumothorax (PSP) was 26.8 years, and that of secondary spontaneous pneumothorax(SSP) was 53.1 years. 330 out of 451 patients(73%) were PSP. The causes of the SSP were mostly pulmonary tuberculosis and COPD: 87 patients(72%), and 24 patients(19.2%), respectively. All the patient were treated by one of the following modalities: 1)rest and oxygen therapy in 42 patients, 2) closed thoracostomy in 208 patients, 3) thoracotomy in 156 patients, 4) VATS bullectomy in 45 patients. The mean duration of postoperative chest tube drainage was as following: thoracotomy 8.3 days, VATS bullectomy 4.7 days. For recent 3 consecutive years, VATS bullectomy has become the more frequently applied operative procedure than thoracotomy in the treatment of surgically indicated PSP, from 33% in 1994 to 78% in 1996. With the minimally invasive thoracoscopic surgery being more prevalent, VATS bullectomy will be able to be the 1st choice of treatment not only for the recurrent pneumothoracies but also for the some selected cases of the 1st episode pneumothoracies. To verify this approach as clinically acceptable one in terms of cost-effectiveness, recurrence rate, etc, a large scale of multi-institutional clinical study will be needed in a sooner time.

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