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Preference of Elementary School Students Compared by Dietitians' Perception in School Lunch Program (학교급식 음료 선호도에 대한 초등학생과 영양사의 인식 비교)

  • Bae, Moon-Hee;Seo, Sun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.8
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    • pp.1083-1093
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    • 2007
  • The purpose of this study was to investigate the difference between students' beverage preference and dietitians' perception in elementary school lunch program. This study was conducted in three phases: (1) questionnaire development and survey administration to elementary school students (2) survey administration to dietitians who were in charge of the elementary school food service, and (3) comparison of beverage preferences between elementary school students and dietitians. In phase I, 703 elementary school students in Seoul were surveyed from July 11 to July 19. In Phase II, 100 school food service dietitians in Seoul participated by mail survey from September 15 to October 30, 2006. Based on the results, elementary school students tended to show a neutral milk preference (mean=3.04), whereas dietitians perceived that elementary school students had lower milk preference (mean=2.67). Also dietitians perceived higher yogurt preference (mean=4.27) than the real elementary school students' preference (mean=4.02). T-test results showed the gender difference on milk and yogurt preference. Male students had higher milk preference (t=4.912, p<0.001) and yogurt preference (t=3.621, p<0.001) than female students. Elementary school students showed high fruit juice preference (mean=4.34); however, dietitians perceived lower fruit juice preference of students (mean=3.92). There was no gender difference on fruit juice preference. Though elementary school students had higher fruit juice preference, the frequency of fruit juice served in school lunch was quite low. Over half of the dietitians reported that they served fruit juice less than once a semester. The results of this study indicated the existence of distinctive difference between students' fruit juice preference and school lunch menu offerings.

Study on the Long-term Forecasting of Brown Planthopper Outbreaks (벼멸구 발생의 장기예찰을 위한 기초적 연구)

  • Paik Woon Hah;Paik Hyun Joon
    • Korean journal of applied entomology
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    • v.16 no.3 s.32
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    • pp.171-179
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    • 1977
  • Since the outbreak of the brown planthopper (Nilaparvata lugens) in 1915 caused tremendous losses in rice production, one of the more effective method of prevention of such a disaster could be the establishment of longterm forecasting system, In 1916 the author indicated there was a correlation between sunspot activities and brown planthopper and the white back planthopper outbreaks. However, the examples seem to be too small size to state a definite correlation. The purpose of the present study IS to revi~w the history of the brown planthopper outbreaks, and to establish a more effective forcasting system. The present forcasting methods are based on light trap catches of adults which already migrate into this country from mainland China. The regular cycle of 11.2 years of sunspot activity began in 1710, and was continued to present. To gather more records of brown planthopper, the author checked 'Joseon Wangjo Silrok' and analized the so-called 'Hwang' 'Hwang-chung' and 'Chung' which have multiple meanings, together with 'Samguk Sagi' 'Goryo Sa' and 'Munheon Bigo.' The results obtained by the about from review of these old literature citations revealed that ten species of insect and unknown species were involved: i. e., pine moth (Dendrolimus spectabilis), army worm (Mythimna separata), brown planthopper (Nilarvata lugens), white-back planthopper (Sogatella furcifera), migratory locust (Locutsa migratoria), rice stem borer (Chilo suppressalis,), mole cricket (Gryllotalpa africana), rice-plant weevil (Echinocnemus squameus), cut worm (Euxoa segetum), and mulberry pyralid Margaronia pyloalis) The suspected incidence of planthopper in old records expressed by 'Hwang' or 'Chung' revealed a total or 25 out of 37 in 'Samguk sagi,' 21 out of 49 in 'Goryo sa,' 9 of 73 in 'Wanjo-silrog,' and none of 8 in 'Munheon bigo' were planthoppers. Therefore, a total of 36 out of 167 records of insect incidence in the old literature can be possibly attributed to planthoppers. The brown planthopper and white-back planthopper migrate together to Korea every year from mainland China, However, the number of each species are differ by year. In 1975 outbreak the brown planthopper was dominant; and the white-back planthopper prevailed in 1946 and 1977 outbreaks, During the course of this study, the author was able to add a new record of outbreak of planthop per. In 1916 the white-back planthopper outbreak caused serious losses in Chungcheong-namdo and Jeonla-namdo, with losses estimated as high as 160 and 190 thousand seok (23.2 and 27.5 thousand M/T), in Naju and Secheon county, respectively. Since 1912, major outbreaks of brown planthopper or white-back planthopper have been recored 5 times. These occurrences coincide and well matched the period of minimum number of sunspots, With these authenticated records of planthoppers, the author believes there is a close correlation between brown planthopper and white-back planthopper outbreaks in Korea and sunspot activities. Therefore, in years of low number of sunspots, we should watch for and expect outbreaks of these. insects. At this time, it will be necessary to provide all possible prevention measures.

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A Study of Current Perception Threshold of Trigeminal Nerve after Tooth Implantation (치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구)

  • Lim, Hyun-Dae;Lee, Jung-Hyun;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.187-200
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    • 2007
  • This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.

The Characteristics of Bronchioloalveolar Carcinoma Presenting with Solitary Pulmonary Nodule (고립성 폐결절로 나타난 기관지폐포암의 임상적 고찰)

  • Kim, Ho-Cheol;Cheon, Eun-Mee;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Lee, Kyoung-Soo;Han, Jung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.280-289
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    • 1997
  • Background : Bronchioloalveolar carcinoma (BAC) has been reported to diveres spectrum of chinical presentations and radiologic patterns. The three representative radiologic patterns are followings ; 1) a solitary nodule or mass, 2) a localized consolidation, and 3) multicentric or diffuse disease. While, the localized consolidation and solitary nodular patterns has favorable prognosis, the multicentric of diffuse pattern has worse prognosis regardless of treatment. BAC presenting as a solitary pulmonary nodule is often misdiagnosed as other benign disease such as tuberculoma. Therefore it is very important to make proper diagnosis of BAC with solitary nodular pattern, since this pattern of BAC is usually curable with a surgical resection. Methods : We reviewed the clinical and radiologic features of patients with pathologically-proven BAC with solitary nodular pattern from January 1995 to September 1996 at Samsung Medical Center. Results : Total 11 patients were identified. 6 were men and 5 were women. Age ranged from 37 to 69. Median age was 60. Most patients with BAC with solitary nodular pattern were asymptomatic and were detected by incidental radiologic abnormality. The chest radiograph showed poorly defined opacity or nodule and computed tomography showed consolidation, ground glass appearance, internal bubble-like lucencies, air bronchogram, open bronchus sign, spiculated margin or pleural tag in most patients. The initial diagnosis on chest X-ray were pulmonary tuberculosis in 4 patients, benign nodule in 2 patients and malignant nodule in 5 patients. The FDG-positron emission tomogram was performed in eight patients. The FDG-PET revealed suggestive findings of malignancy in only 3 patients. The pathologic diagnosis was obtained by transbronchial lung biopsy in 1 patient, by CT guided percutaneous needle aspiration in 2 patients, and by lung biopsy via video-assited thoracocopy in 8 patients. Lobectomy was performed in all patients and postoperative pathologic staging were $T_1N_0N_0$ in 8 patients and $T_2N_0M_0$ in 3 patients. Conclusion : Patients of BAC presenting with solitary nodular pattern were most often asymptomatic and incidentally detected by radiologic abnormality. The chest X-ray showed poorly defined nodule or opacity and these findings were often regarded as benign lesion. If poorly nodule or opacity does not disappear on follow up chest X-ray, computed tomography should be performed. If consolidation, ground glass appearance, open bronchus sign, air bronchogram, internal bubble like lucency, pleural tag or spiculated margin are found on computed tomography, further diagnostic procedures, including open thoracotomy, should be performed to exclude the possiblity of BAC with solitary nodular pattern.

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Efficacy and Safety of Early Bronchoscopy in Patients with Hemoptysis (객혈환자에서 조기기관지경의 유용성 몇 안정성)

  • Kim, Ho-Cheol;Cheon, Eun-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.391-400
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    • 1997
  • Background : Bronchoscopy is an essential procedure for identifying the bleeding site and evaluating cause of hemoptysis. However, it is controversial regarding to the timing of bronchoscopy in patients with hemoptysis. Early bronchoscopy, which was performed during hemoptysis or with 48hour after cessation of bleeding, was better for identifying the site of bleeding compared with delayed bronchoscopy, which was performed 48 hours after cessation of bleeding. The diagnostic yield of identifying the bleeding site by bronchoscopy was variable in reported literature and the safety of early bronchoscopy was not mentioned in previous literature. Therefore, we evaluated the efficacy and safety of early bronchoscopy in patients with hemoptysis. Method : From October 1994 to August 1996 in Samsung Medical Center, bronchoscopy was performed in patients with hemoptysis. Early bronchoscopy was performed prospectively during hemoptysis or within 48 hours after cessation of bleeding from May 1995 to August 1996. Delayed bronchoscopy group included patients who did not received early bronchoscopy at the same period or in whom bronchoscopy was performed 48 hour after cessation of bleeding from October 1994 to May 1995. Results : Early bronchoscopy group was performed 73 times in 71 patients. Delayed bronchoscopy was performed in 57 times in 55 patients. There was no difference as to amount and underlying cause of hemoptysis between both groups. Indentification of bleeding site by visualizing active bleeding was significantly higher in early bronchoscopy (38.3%) than delayed bronchoscopy group (8.7%)(p < 0.05). Indentification of bleeding site by bleeding after clot removal was 8 in early and 10 in delayed bronchoscopy. Indentification of bleeding site by visualizing active bleeding and bleeding after clot removal was 36 in early and 15 patients in delayed bronchoscopy(p > 0.05). Causes of hemoptysis was found in 18 patients in early and 16 patients in delayed bronchoscopy group. patients who had early bronchoscopy underwent surgery. We diagnosed the site of bleeding in 4 patients preoperatively. In 3 patients we made a treatment plan promptly right after bronchoscopy. Among early bronchoscopy group, bleeding over 100cc during bronchoscopy occurred in 2 patients. In early bronchoscopy group there was no other major complication during bronchoscopy. Conclusion : In patients with hemoptysis, early bronchoscopy which performed within 48 hours after cessation of bleeding was more effective procedure for identifying the bleeding site than delayed bronchoscopy which was performed after 48 hour cessation of bleeding.

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The Influence of Obstructive Sleep Apnea on Systemic Blood Pressure, Cardiac Rhythm and the Changes of Urinary (폐쇄성 수면 무호흡이 전신성 혈압, 심조율 및 요 Catecholamines 농도 변화에 미치는 영향)

  • Lo, Dae-Keun;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.153-168
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    • 1998
  • Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

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The Effect of Glucocorticoid on the Change of Nitric Oxide and Cytokine Levels in Induced Sputum from Patients with Bronchial Asthma (기관지 천식 환자에서 부신피질 스테로이드 투여 전후 유도객담내 Nitric Oxide 및 Cytokine의 변화)

  • Kim, Tae-Yon;Yoon, Hyeong-Kyu;Choi, Young-Mee;Lee, Sook-Young;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.922-931
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    • 2000
  • Background : It has been well known that bronchia1 asthma is a chronic airway inflammatory disorder. Recently, sputum induced with hypertonic saline was introduced as a simple and useful nonivasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, eosinophil cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating facta (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchia1 asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation or changes in pulmonary function tests and symptoms. Methods : A total 30 patients with bronchia1 asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second ($FEV_1$), total blood eosinophil count and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. Results : Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in $FEV_1$ (% of predicted value) from 78.1$\pm$20.6 % to 90.3$\pm$ 18.3 % (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1$\pm$27.2 % versus 29.6$\pm$21.3 % (P<0.001), and ECP were $134.5\pm68.1\;{\mu}g/L$ versus $41.5\pm42.4\;{\mu}g/L$ (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7$\pm$12.8 pg/ml to 21.7$\pm$8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count (425.7$\pm$265.9 vs 287.7$\pm$294.7) and in the concentration of NO derivatives ($70.4\pm44.6{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) after the prednisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments or after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-D.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05) Conclusion : The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchia1 asthma. In addition, the measurement of sputum eosinophil percent ages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the prednisolone treatment in bronchia1 asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.

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The Influences of Maintenance Hemodialysis on Sleep Architecture and Sleep Apnea in the Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 유지요법이 수면구조 및 수면 무호흡에 미치는 영향)

  • Park, Yong-Geun;Lee, Sang-Haak;Choi, Young-Mee;Ahn, Seok-Joo;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.824-835
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    • 1999
  • Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

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Prospective Study on Preoperative Evaluation for the Prediction of Mortality and Morbidity after Lung Cancer Resection (폐암절제술후 발생하는 사망 및 합병증의 예측인자 평가에 관한 전향적 연구)

  • Park, Jeong-Woong;Suh, Gee-Young;Kim, Ho-Cheol;Cheon, Eun-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Kim, Kwan-Min;Kim, Jin-Kook;Shim, Young-Mok;Rhee, Chong-H.;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.57-67
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    • 1998
  • Purpose : This study was undertaken to determine the preoperative predictors of mortality and morbidity after lung cancer resection. Method: During the period from October 1, 1995 to August 31, 1996, a prospective study was conducted in 92 lung resection candidates diagnosed as lung cancer. For preoperative predictors of nonpulmonary factors, we considered age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness, and for those of pulmonary factors, smoking history, presence of pneumonia, dyspnea scale(1 to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test. And predicted postoperative(ppo) pulmonary factors such as PPO-$FEV_1$, ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}ppo$-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also considered. Results: There were 78 men and 14 women with a median age of 62 years(range 42 to 82) and a mean $FEV_1$ of $2.37\pm0.06L$. Twenty nine patients had a decreased $FEV_1$ less than 2.0L. Pneumonectomy was performed in 26 patients, bilobectomy in 12, lobectomy in 54. Pulmonary complications developed in 10 patients, cardiac complications in 9, other complications(empyema, air leak, bleeding) in 11, and 16 patients were managed in intensive care unit for more than 48hours. Three patients died within 30 days after operation. The ppo-$VO_2$max was less than 10ml/kg/min in these three patients, but its statistical significance could not be determined due to small number of patients. In multivariate analysis, the predictor related to postoperative death was weight loss(p<0.05), and as for pulmonary complications, weight loss, dyspnea scale, ppo-DLco and extent of resection(p<0.05). Conclusions: Based on this study, preoperative nonpulmonary factors such as weight loss and dyspnea scale are more important than the pulmonary factors in the prediction of postoperative mortality and/or morbodity in lung resection candidates, but exercise pulmonary fuction test may be useful Our study suggests that ppo-$VO_2$max value less than 10ml/kg/min is associated with death after lung cancer resection but further studies are needed to validate this result.

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Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule (고립성폐결절의 진단시 FDG-PET의 임상적 유용성에 관한 연구)

  • Cheon, Eun Mee;Kim, Byung-Tae;Kwon, O. Jung;Kim, Hojoong;Chung, Man Pyo;Rhee, Chong H.;Han, Yong Chol;Lee, Kyung Soo;Shim, Young Mog;Kim, Jhingook;Han, Jungho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.882-893
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    • 1996
  • Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

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