• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.71-79
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• 2003

Background : A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. Methods : Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia ($PaO_2/FIO_2$ ratio ${\leq}200$ on oxygen 10 L/min via mask with reservoir bag) were enrolled. The CPAP 5-6 $cmH_2O(F_IO_2\;1.0)$ was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. Results : (1) Median age was 56 years(male:female=4:3). (2) The baseline $PaO_2$ was $78{\pm}16mmHg$, which increased significantly to $269{\pm}116mmHg$(p=0.018) with CPAP. After the BAL, the $PaO_2$ did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The $SpO_2$ showed a similar trend with the $PaO_2$ and did not decrease to below 90 % during the duration of the study. (3) The $PaCO_2$ increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. Conclusion : In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.

• Sijohaknonchong
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• v.30
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• pp.263-300
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• 2009

Adoration for nature constitutes one of the primary subjects that literature has tackled since the origin of human history. Nature expressed through a poet's subjective imagination is the internalized and reorganized nature. This study examines the view on nature enacted in Ch'o-Jung's three-verse poems (sijo) in light of the traditional views on nature implicated in the ancient three-verse poems (koshijo), which is in line with the long-established Oriental view on nature. To dignitaris(sadaebu) in the Chosun Dynasty, nature appeared as the idealistic subject for moral culture ($shims{\breve{o}}ngsuyang$), which also becomes the literary space where the purity and justice of the world view of Neo-Confucianism(Sungrihak) is contained in the form of the three-verse poem, the lyrical poetic space where the "I" is united with nature by way of "enjoying of wind and moon"($umpungnongw{\breve{o}}i$) and "living in quiet retiremen"($yuyuchaj{\breve{o}}k$), and the object for the poetical perception of the surrounding world. Ch'o-Jung' s three-verse odes are found in Reed pipe ($Ch'oj{\breve{o}}k$), Sixty Five Pieces of Three-Verse Odes (Samhaengshi-$yukshipopy{\breve{o}}n$), Autumn Fragrance ($Hyangginam{\check{u}}n-ga{\check{u}}l$), and The Words of Zelko va Tree ($N{\check{u}}tinamu{\check{u}}i-mal$). This study analyzes 212 pieces of Ch'o-Jung' s three-verse poems chosen from theses books. In Ch'o-Jung's poems, the traditional view on nature expressed in the ancient three-verse poems is rendered in such a way that metaphysical understanding of nature is indirectly transmitted through the objective correlatives found nature. Nature is no longer the object of straightforward utterance, but transformed, displaced, and removed: that way, nature gets objectified to form a complicated and multi-layered structure. In conclusion, the view on nature manifested in Ch'o-Jung's three-verse poems is based on traditional metaphysics. Second, nature is the object of lyrical nostalgia and adoration. Third, nature is imbued with the fundamental affection for parents. Fourth, nature is associated with organic life. Fifth, the nature in Ch'o-Jung's poems reveals the beauty of stillness endorsed in Lao-tse's and Chung-tze's philosophy. And last, nature is the agent for self-realization and meditation.

• Journal of Korean Society of Forest Science
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• v.80 no.1
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• pp.54-71
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• 1991

To classify and analyze the forest communities and their structures, the vegetation in Mt. Joghe was investigated from July, 1980 to August, 1989. The results obtained are as follow ; 1. A total of 750 kinds of vascular plant(49 orders, 122 families, 434 genera, 627 species, 1 subspecies, 111 varieties and 11 forma)were observed in Mt. Ioghe. The newly observed plant species were Dioscorea quingueloba, Spiranthes sinensis, Cephalanthera falcata, Angelica gigas, Clematis patents, Paeonia obovata, Hibiscus mulabilis, Ainsliaea acerifolia, Dictamnus dasycarpus, Cynachum ascyrifolia, Vaccinium koreanum, Erythrortium japonicum, Indigofera kirilowii (17species), Broussonetia kazinoki var, humillis, Euonymus, fortunei var. radicans, Juniperus communis var, nippnnica, Callicarpa japonica var. radicans, Joniperus communis var. rzipponica, Callicarpa japonica var. taquetii (4 varieties) and L indera obtusiloba for. billosum (1 forma). 2. The life spectrum of flora in Mt. Joghe was classified into $CH-D_1-R_5-e$ type. Distribution area was identical to Southern type by Nakai, Lee, and Yim. A few subtropical species were also observed. 3. Simpson's species diversity index(Ds) was 0.9 and Shannon-Weiner's diversity index (H') was 1.004. These indice suggest that the vegetation in Mt. Joghe is of complicated forest communities. 4. Pte-Q was 1.81 which was higher than the nationwide mean of 1.68. Urbanization Index (UI) was 28.75 for naturalized plant species, and 17.49 for exotic woody plant species, which were similar to those of Mt. Baekun and Mt. Naejang. 5. The forest vegetation of Mt. Joghe was grouped in 3 vegetation types : 7 natural plant Communities dominated by Quercus serrat, Quercus acutissima, Quercus variabilis, Carpinus laxiflora, Pinus derasiflora and Platycarya strobilacea, 8 substitutional plant communities Styrax japonica, Stewartia koreana, Lindera erytlrrocarpa, Zelkova serrata, Rhtrs chinensis, Controversa, and Frzrxirtus manrlshurica, and 7 plantation Communities composed of Pinus koraiensis, Pinus rigida, Magnolia nbnvata, Chamecyparis obkrsa, Larie ieptolepis, Castanea crenata and Cryptomeria japonica. 6. Actual vegetation maps and profile diagrams were made by phytosocialogical classification. 7. As the important and unique species in Mt. Joghe, Lindera sericea, Penicaria tilitorme, Hex macropoda, Hex macropoda for. pseudo-macropoda, Steroartia koreana, Adenopkora palustris and Corylop.,is coreana, which were also seported by Lee(1977), Kim and Yark(1989), were identified and Vaccinium coreanum, Cremastra appendiculinium, Juniperus comminis van. nipponica, Cephalanthera falcata, Broussortetia kazinoki var. humilis, paeonia obovata, Deutzia prunifolia, Dictamnus dasyarpus, Angelica gigics and Bupleurum falcatum were odditionally observed.

• Tuberculosis and Respiratory Diseases
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• v.48 no.6
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• pp.932-943
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• 2000

Background : Nonspecific interstitial pneumonitis (NSIP) is most likely to be confused with usual interstitial pneumonitis (UIP). Unlike patients witþ UIP, the majority of patients with NSIP have a good prognosis, with most patients improving after treatment with corticosteroids. Therefore it is clinically important to differentiate NSIP from UIP. Up to now, the only means of differentiating these two diseases was by means of surgical lung biopsy. American Thoracic Society (ATS) proposed a clinical diagnostic criteria for UIP to provide assistance to clinicians in its diagnosis without surgical lung biopsy. This study is aimed to investigate whether there were clinical and radiological differences between NSIP and UIP, and the usefulness of ATS clinical diagnostic criteria for UIP in Korea. Methods : We studied 60 patients with UIP and NSIP confirmed by surgical lung biopsy. Clinical manifestations, pulmonary function test, arterial blood gas analysis, bronchoalveolar lavage (BAL), and high resolution computed tomography (HRCT) were evaluated and analyzed by Chi-square test or t-test. The clinical criteria for UIP proposed by ATS were applied to all patients with idiopathic interstitial pneumonia. Results : Forty-two patients with UIP and 18 with NSIP were pathologically identified. Among the 18 patients with NSIP (M : F=1 : 17), the mean age was 55.2$\pm$8.4 (44~73) yr. Among the 42 patients with UIP (M : F=33 : 9), the mean age was 59.5$\pm$7.1 (45~74) yr (p=0.046). Fever was more frequent in NSIP (39%) (p=0.034), but clubbing was frequently observed in UIP (33%) (p=0.023). BAL lymphocytosis was more frequent (23%) (p=0.0001) and CD4/CD8 ratio was lower in NSIP (p=0.045). On HRCT, UIP frequently showed honeycomb appearance (36 of 42 patients) though not in NSIP (p=0.0001). Six of 42 UIP patients (14.3%) met the ATS clinical criteria for IPF, and 3 of 16 NSIP patients (18.8%) met the diagnostic criteria. Conclusion : Being a relatively young female and having short duration of illness, fever, BAL lymphocytosis, low CD4/CD8 ratio with the absence of clubbing and honeycomb appearance in HRCT increase the likelihood of the illness being NSIP. The usefulness of ATS clinical diagnostic criteria for UIP may be low in Korea.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.442-450
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• 1999

Background : Isoniazid(INH) and rifampicin(RFP) are the most effective anti-tuberculosis drugs which make the short-course chemotherapy possible. Although prescribed dosages of INH and RFP in Korea are different from those recommended by American Thoracic Society, there has been few study about pharmacokinetic profiles of INH and RFP in Korean patients who receive INH, RFP, ethambutol(EMB) and pyrazinamide(PZA) simultaneously. Methods : Among the patients with active tuberculosis from Dec. 1997 to July 1998, we selected 17 patients. After an overnight fast, patients were given INH 300mg, RFP 450mg, EMB 800mg and PZA 1500mg daily. Blood samples for the measurement of plasma INH(n=15) and RFP(n=17) level were drawn each at 0, 0.5, 1, 1.5, 2, 4, 6, 8 and 12hrs, and urine was also collected. INH and RFP level in the plasma and the urine were measured by high-performance liquid chromatography(HPLC). Pharmacokinetic parameters such as peak serum concentration(Cmax), time to reach to peak serum concentration(Tmax), half-life, elimination rate constant(Ke), total body clearance(CLtot), nonrenal clearance(CLnr), and renal clearance(CLr) were calculated. Results : 1) Pharmacokinetic parameters of INH were as follows: Cmax; $7.63{\pm}3.20{\mu}g/ml$, Tmax; $0.73{\pm}0.22hr$, half-life; $2.12{\pm}0.84hrs$, Ke; $0.83{\pm}0.15hrs^{-1}$, CLtot; $17.54{\pm}8.89L/hr$, CLnr; $14.74{\pm}8.35L/hr$, CLr; $2.79{\pm}1.31L/hr$. 2) Pharmacokinetic parameters of RFP were as follows: Cmax; $8.93{\pm}3.98{\mu}g/ml$, Tmax; $1.76{\pm}1.13hrs$, half-life; $2.27{\pm}0.54hrs$, Ke; $0.32{\pm}0.08hrs^{-1}$, CLtot; $14.63{\pm}6.60L/hr$, CLr; $1.04{\pm}0.55L/hr$, CLnr; $13.59{\pm}6.21L/hr$. 3) While the correlation between body weight and Cmax of INH was not statistically significant (r=-0.514, p value>0.05), Cmax of RFP was significantly affected by body weight of the patients(r=-0.662, p value<0.01). Conclusion : In Korean patients with tuberculosis, 300mg of INH will be sufficient to reach the ideal peak blood level even in the patients over 50kg of body weight However, 450mg of RFP will not be the adequate dose in the patients who weigh over 50~60kg.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1199-1213
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• 1998

Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.

• 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.

• 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.

• Korean journal of applied entomology
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• v.14 no.3 s.24
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• pp.97-109
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• 1975

In an attempt to develop an effective integrated system of controlling blast disease of rice caused by Pyricularia oryzae Cav., the possibility of minimizing the disease incidence by proper application of fertilizers has been investigated. Thus the effect of silicate, nitrogen, phosphorus and potassium fertilizers on the development of blast disease as well as the correlation between the rice varieties an4 strains of P. oryzae were studied. The experiments were made in 1971 and 1973 by artificial inoculation and under natural development of the blast disease on rice plants. The results obtained are summarized as follows. 1. Application of silicate fertilizer resulted in the increase of silicate as well as total sugar and potassium content but decrease of total nitrogen and phosphorus in tile leaf blades of rice plants. 2. The ratios of total C/total N. $ SiO_2/total$ N, and $K_2O/total$ N in leaf blades of rice plants increased by the application of silicate fertilizers. There was high level of negative correlation between the ratios mentioned above and the incidence of rice blast disease. 3. Application of silicate fertilizer reduced the incidence of rice blast disease. 4. The over dressing of nitrogen fertilizer resulted in the increase of total nitrogen and decrease of silicate and total sugar content in leaf blades, thus disposing the rice plants more susceptible to blast disease. 5. Over dressing of phosphorus fertilizer resulted in the increase of both total nitrogen and Phosphorus, and decrease of silicate content in the leaf blades inducing the rice plants to become more susceptible to blast disease. 6. Increased dressing of potash resulted in the increase of silicate content and $K_2O/total$ N ratio but decrease of total nitrogen content in leaf blades. When potassium content is low in the leaf blades of rice plants, the additional dressing of potash to rice plant contributed to the increase of resistance to blast disease. However, there was no significant correlation between additional potassium application and the resistance to blast disease when the potassium content is already high in the leaf blades. 7. When four rice varieties were artificially inoculated with three strains of P. oryzae, the incidence of blast disease was most severe on Pungok, least severe on Jinheung and moderate on Pungkwang and Paltal varieties. 8. Disease incidence was most severe on the second leaf from top and less sever on top and there leaf regardless of the fertilizer application when 5-6 leaf stage rice seedlings of four rice varieties were artificially inoculated with three strains of P. oryzae. 9. The pathogenicity of three strains of P. oryzae was in the order of $P_1,\;P_2,\;and\;P_3$ in their virulence when inoculated to Jinheung, Paltal, Pungkwang varieties but not with Pungok. The interaction between strains of P. oryzae and rice varieties was significant.

• Tuberculosis and Respiratory Diseases
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• v.48 no.1
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• pp.14-23
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• 2000

Background: The evaluation of candidates for successful lung resection is important. Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. Method; Between October 1, 1995 and August 31, 1997, 36 lung resection candidates for lung cancer with $FEV_1$ of less than 2L or 60% of predicted value were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(l to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, 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 measured. Results: There were 31 men and 5 women with the median age of 65 years(range, 44 to 82) and a mean $FEV_1$ of $1.78{\pm}0.06L$. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients; cardiac complications in 3, other complications(empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-$VO_2$max was less than 10 ml/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictor for the post operative death in this study. Conclusions: Based on the results, MVV was the useful predictor for postoperative pulmonary complications in lung cancer resection candidates with impaired lung function In addition, ppo-$VO_2$max value less than 10 ml/kg/min was associated with postoperative death, so exercise pulmonary function test could be useful as preoperative test. But further studies are needed to validate this result.