• Title/Summary/Keyword: 손상확산

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Early Response of Cardiopulmonary Exercise Test(CPET) in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Radiation (방사선 치료 후 폐암환자의 운동부하 심.폐 기능의 초기변화)

  • Shin, Kyeong-Cheol;Lee, Deok-Hee;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.466-473
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    • 2000
  • Background : Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. Method : Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. Results : The forces vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$ and maximal voluntary ventilation (MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity (DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption ($VO_2$max), carbon dioxide production ($VCO_2$), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. Conclusion : Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.

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Clinical Utility of Prominent Hypointense Signals in the Draining Veins on Susceptibility-Weighted Imaging in Acute Cerebral Infarct: As a Marker of Penumbra and a Predictor of Prognosis (급성 뇌경색에서 자화율강조영상에서 보이는 현저한 유출정맥 저신호 강도의 임상적 유용성: Penumbra 및 예후 예측인자로서 가능성)

  • Lee, Hyun Sil;Ahn, Kook Jin;Choi, Hyun Seok;Jang, Jin Hee;Jung, So Lyung;Kim, Bum Soo;Yang, Dong Won
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.332-340
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    • 2014
  • Purpose : A relative increase in deoxyhemoglobin levels in hypoperfused tissue can cause prominent hypointense signals in the draining veins (PHSV) within areas of impaired perfusion in susceptibility-weighted imaging (SWI). The purpose of this study is to evaluate the usefulness of SWI in patients with acute cerebral infarction by evaluating PHSV within areas of impaired perfusion and to investigate the usefulness of PHSV in predicting prognosis of cerebral infarction. Materials and Methods: In 18 patients with acute cerebral infarction who underwent brain MRI with diffusion-weighted imaging and SWI and follow-up brain MRI or CT, we reviewed the presence and location of the PHSV within and adjacent to areas of cerebral infarction qualitatively and measured the signal intensity difference ratio of PHSVs to contralateral normal appearing cortical veins quantitatively on SWI. The relationship between the presence of the PHSV and the change in the extent of infarction in follow-up images was analyzed. Results: Of the 18 patients, 10 patients showed progression of the infarction, and 8 patients showed little change on follow- up imaging. On SWI, of the 10 patients with progression 9 patients showed peripheral PHSV and the newly developed infarctions corresponded well to area with peripheral PHSV on initial SWI. Only one patient without peripheral PHSV showed progression of the infarct. The patients with infarction progression revealed significantly higher presence of peripheral PHSV (p=0.0001) and higher mean signal intensity difference ratio (p=0.006) comparing to the patients with little change. Conclusion: SWI can demonstrate a peripheral PHSV as a marker of penumbra and with this finding we can predict the prognosis of acute infarction. The signal intensity difference of PHSV to brain tissue on SWI can be used in predicting prognosis of acute cerebral infarction.

The Measurement of $^{99m}Tc-DTPA$ Pulmonary Clearance in Normals, Asymptomatic Smokers and Diabetic Patients (정상 성인, 무증상 흡연자, 당뇨병 환자에서 $^{99m}Tc-DTPA$ 폐제거율의 측정)

  • Kim, In-Ju;Kim, Seong-Jang;Kim, Yong-Ki;Kim, Yun-Seong;Lee, Min-Ki;Park, Soon-Kew
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.266-275
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    • 1998
  • Purpose: We measured pulmonary epithelial permeability by $^{99m}Tc-DTPA$ radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate $^{99m}Tc-DTPA$ radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. Materials and Methods: We performed $^{99m}Tc-DTPA$ radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) was calculated, then compared with the result of chest radiography and pulmonary function test. Results: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiopathy were significantly older (p<0.05). The $T_{1/2}$ of normal subjects and asymptomatic smokers were significantly different ($65.2{\pm}23.7min$ vs $39.6{\pm}9.8min$, p<0.05). For diabetic patients with microangiopathy, the $T_{1/2}$ was $90.5{\pm}46.5min$ and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the $T_{1/2}$ of diabetic patients without microangiopathy, $70.0{\pm}12.7min$, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the $T_{1/2}$ and spirometric parameters including DLco, FVC, $FEV_1,\;FEV_1/FVC$ (%) and $FEF_{25-75%}$ in all subjects, and between the $T_{1/2}$ and duration of diabetes ;in diabetic patients. Conclusion: Eventhough the influence of age can't be excluded, delayed $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.

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A Study on the Change of Materials and Fabrication Techniques of Stone Figures in Royal Tombs of the Joseon Period - Focusing on Shindobi, Pyo-Seok, and Sang-Seok - (조선시대 왕릉 석물의 재료와 제작 방법 변화에 관한 연구 - 신도비와 표석, 상석을 중심으로 -)

  • Cha, Moonsung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.56-77
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    • 2019
  • Bi-Seok is a treasure trove of funeral rites and an important cultural asset that can shed light on the historical and social history of calligraphy, but research of the topic is still insignificant. In particular, research on the production method of Bi-Seok remains an unproven field. The production of Bi-Seok can be roughly divided into ma-jeong (refining stone), sculpture, and the Buk-chil (process of engraving letters) process. This article reveals some facts: First, performing ma-jeong to the Sang-Seok, Honyu-Seok, Bi-seok, which are known to be God's things. This process is needed because of the change in the perception of the Honyu-Seok due to the settlement and propagation of Confucian ceremonial rituals in the times of hardship in 1592 and 1636. As the crafting process of ma-jeong did not remain concrete, it was only possible to examine the manufacturing process of Bi-Seok through its materials and tools. Second, the rapid proliferation of Oh-Seok and Sa-jeo-chwi-yong (purchase of things made by private citizens) in the Yeongjo era has great importance in social and cultural history. When the Gang-Hwa-Seok of the commodity were exhausted, the Oh-Seok that was used by Sadebu (upper civil class) were used in the tomb of Jangneung, which made Oh-Seok popular among people. In particular, the use of Oh-Seok and the Ma-Jeong process could minimize chemical and physical damage. Third, the writing method of the Bi-seok is Buk-chil. After Buk-Chil of Song Si-Yeol was used on King Hyojong's tomb, the Buk-Chil process ( printing the letters on the back of the stone and rubbing them to make letters) became the most popular method in Korea and among other East Asian countries, and the fact that it was institutionalized to this scale was quite impressive. Buk-Chil became more sophisticated by using red ink rather than black ink due to the black color that results from Oh-Seok. Fourth, the writing method changes in the late Joseon Dynasty. Until the time of Yeongjo's regime, when inscribing, the depth of the angle was based on the thickness of the stroke, thus representing the shade. This technique, of course, did not occur at every Pyo-Seok or Shindobi, but was maintained by outstanding artisans belonging to government agencies. Therefore, in order to manufacture Bi-Seok, Suk-seok, YeonJeong, Ma-jeong, Jeong-Gan, ChodoSeoIp, Jung-Cho, Ip-gak, Gyo-Jeong, and Jang-Hwang, a process was needed to make one final product. Although all of these methods serve the same purpose of paying respects and propagandizing the great work of deceased persons, through this analysis, it was possible to see the whole process of Pyo-Seok based upon the division of techniques and the collaboration of the craftsmen.

Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province (가정용 인공호흡기를 사용하는 서울 및 경기 지역 환자의 실태)

  • Ahn, Jong-Joon;Lee, Ki-Man;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.624-632
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    • 2000
  • Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

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