• Title/Summary/Keyword: 연구개

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Clinical Features and Treatment Response in 18 Cases with Idiopathic Nonspecific Interstitial Pneumonia (특발성 비특이성 간질성 폐렴 18례의 임상상 및 치료반응)

  • Kang, Eun-Hae;Chung, Man-Pyo;Kang, Soo-Jung;An, Chang-Hyeok;Ahn, Jong-Woon;Han, Joung-Ho;Lee, Kyung-Soo;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.530-542
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    • 2000
  • Background : Nonspecific interstitial pneumonia (NSIP) has been reported recently to have shown much better response to medical treatment and better prognosis compared with idiopathic UIP. However, clinical characteristics of idiopathic NSIP discriminating it from UIP have not been clearly defined. Method : Among 120 patients with biopsy-proven diffuse interstitial lung diseases admitted to the Samsung Medical Center between July 1996 and March 2000, 18 patients with idiopathic NSIP were included in this study. Retrospective chart review and radiographic analysis were performed. Results : 1) At diagnosis, 17 patients were female and the average age was $55.2{\pm}8.4$ years (44~73 years). The average duration from development of respiratory symptom to surgical lung biopsy was $9.9{\pm}17.1$ months. Increase in bronchoalveolar lavage fluid lymphocytes ($23.0{\pm}13.1%$) was noted. On HRCT, ground glass and irregular linear opacity were observed, but honeycombing was absent in all patients. 2) Corticosteroids were initially given to 13 patients, but the medication was stopped in 3 patients due to severe side effects. Further medical therapy was not possible in 1 patient who experienced streroid-induced psychosis. Herpes zoster (n=3), tuberculosis (n=1), avascular necrosis of the hip (n=1), cataract (n=2) and diabetes mellitus (n=1) developed during prolonged corticosteroid administration. Of the 7 patients receiving oral cyclophosphamide therapy, hemorrhagic cystitis hindered one patient from continuing with the medication. 3) After medical treatment, 14 of 17 patients improved, and 3 patients remained stable (mean follow-up ; $24.1{\pm}11.2$ months). FVC increased by $20.2{\pm}11.2%$ of predicted value and the extent of ground glass opacity on HRCT decreased significantly ($15.7{\pm}14.7%$). 4) Of the 14 patients who had stopped medication, 5 showed recurrence of NSIP and 2 became aggravated during steroid tapering. All patients with recurrence showed deterioration within one year after completion of initial treatment. Conclusion : Since idiopathic NSIP has unique clinical profiles and shows good prognosis, diagnosis different from UIP, and aggressive medical treatment are needed.

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Effect of Bronchial Artery Embolization(BAE) in Management of Massive Hemoptysis (대량 객혈환자에서 기관지 동맥색전술의 효과)

  • Yeo, Dong-Seung;Lee, Suk-Young;Hyun, Dae-Seong;Lee, Sang-Haak;Kim, Seok-Chan;Choi, Young-Mee;Suh, Ji-Won;Ahn, Joong-Hyun;Song, So-Hyang;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Kim, Ki-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.53-64
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    • 1999
  • Background : Massive and untreated hemoptysis is associated with a mortality of greater than 50 percent. Since the bleeding is from a bronchial arterial source in the vast majority of patients, embolization of the bronchial arteries(BAE) has become an accepted treatment in the management of massive hemoptysis because it achieves immediate control of bleeding in 75 to 90 percent of the patients. Methods: Between 1990 and 1996, we treated 146 patients with hemoptysis by bronchial artery embolization. Catheters(4, 5, or 7F) and gelfoam, ivalon, and/or microcoil were used for embolization. Results: Pulmonary tuberculosis and related disorders were the most common underlying disease of hemoptysis(72.6%). Immediate success rate to control bleeding within 24hours was 95%, and recurrence rate was 24.7%. The recurrence rate occured within 6 months after embolization was 63.9%. Initial angiographic findings such as bilaterality, systemic-pulmonary artery shunt, neovascularity, aneurysm were not statistically correlated with rebleeding tendency(P>0.05). Among Initial radiographic findings, only pleural lesions were significantly correlated with rebleeding tendency(P<0.05). At additional bronchial artery angiograpy done due to rebleeding, recanalization of previous embolized arteries were 63.9%, and the presence of new feeding arteries were 16.7%, and 19.4% of patients with rebleeding showed both The complications such as fever, chest pain, headache, nausea and vomiting, arrhythmia, paralylytic ileus, transient sensory loss (lower extremities), hypotension, urination difficulty were noticed at 40 patients(27.4%). Conclusion: We conclude that bronchial artery embolization is relatively safe method achieving immediate control of massive hemoptysis. At initial angiographic findings, we could not find any predictive factors for subsequent rebleeding. It may warrant further study whether patients with pleural disease have definetely increased rebleeding tendency.

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Quality characteristics of rice and rice starch-based Yakju (쌀 및 쌀 전분을 활용한 약주의 품질특성)

  • Kang, Ji-Eun;Kim, Jae-Woon;Choi, Han-Seok;Kim, Chan-Woo;Yeo, Soo-Hwan;Jeong, Seok-Tae
    • Food Science and Preservation
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    • v.22 no.3
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    • pp.353-360
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    • 2015
  • Yakju, a Korean traditional alcoholic beverage, is made from rice and Nuruk. In this study, the fermentation characteristics of Yakju was investigated using rice and rice starch. Ingredients was classified into raw material (rice, rice starch) and starter (enzyme supplements, modified Nuruk, traditional Nuruk, and yellow rice koji) for fermentation. The crude protein content of rice, rice starch, and starter were determined as follows (%): rice 6.69, rice starch 0.44, enzyme supplements 7.84, modified Nuruk 15.29, traditional Nuruk 14.28, and yellow rice koji 7.28. The alcohol content of rice with traditional Nuruk ($20.13{\pm}0.12%$) was higher than other Yakju. The concentration of organic acids of rice starch-based Yakju (389.83~538.34 mg%) was higher than that of rice Yakju (259.27~357.70 mg%). The concentration of nitrogen compound of rice Yakju (498.38~5976.93 ppm) was higher than that of rice starch-based Yakju (600.43~4463.79 ppm). In line with these findings, further studies will be necessary for the quality analysis of the rice, rice starch and fermented starter (enzyme supplements, modified Nuruk, traditional Nuruk and yellow rice koji).

APICAL FITNESS OF NON-STANDARDIZED GUTTA-PERCHA CONES IN SIMULATED ROOT CANALS PREPARED WITH ROTARY ROOT CANAL INSTRUMENTS (전동화일로 형성된 근관에서 비표준화 Gutta-percha Cone의 적합성)

  • Kwon, O-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.25 no.3
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    • pp.390-398
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    • 2000
  • The purpose of this study was to evaluate the apical fitness of non-standardized gutta-percha cones in root canals prepared with rotary Ni-Ti root canal instruments of various tapers and apical tip sizes. Simulated sixty curved root canals of plastic blocks were prepared with crown-down technique using rotary root canal instruments of Maillefer ProFile$^{(R)}$ .04 and .06 taper (Maillefer Instrument SA, Switzerland). Specimens were divided into six groups and prepared as follows: Group 1, prepared up to size 25 of .04 taper ; Group 2, prepared up to size 30 of .04 taper ; Group 3, prepared up to size 35 of .04 taper ; Group 4, prepared up to size 25 of .06 taper ; Group 5, prepared up to size 30 of .06 taper ; Group 6 ; prepared up to size 35 of .06 taper. After cutting off the coronal portion of plastic, blocks perpendicular to the long axis of the canal with the use of a diamond saw, apical 5mm of canal space was analyzed. Prepared apical canal spaces were duplicated using rubber base impression material to evaluate two dimensional total area of apical canal space. Various sized gutta-percha cones were applied in the 5mm-apical canal space, which were size 25, size 30 and size 35 standardized gutta-percha cone, Diadent Dia-Pro ISO-.04$^{TM}$ and .06$^{TM}$(Diadent, Korea), and medium-fine (MF), fine (F), fine-medium (FM) and medium (M) sized non-standardized gutta-percha cones (Diadent, Korea). Coronal excess gutta-percha were cut off with a sharp blade. Photographs of impressed apical canal spaces and gutta-percha cones were taken with a CCD camera under a stereomicroscope and stored in a computer. Areas of the total canal space and gutta-percha cones were calculated using a digitalized image analysing program, CompuScope (Sungjin Multimedia Co., Korea). Ratio of apical fitness was obtained by calculating the area of gutta-percha cone to the total area of the canal space. The data were analysed statistically using One-way Analysis of Variance and Duncan's Multiple Range Test. The results were as follows: 1. In canals prepared up to size 25 ProFile$^{(R)}$ of .04 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 25 standardized ones (p<0.05). 2. In canals prepared up to size 30 ProFile$^{(R)}$ of .04 taper, non-standardized F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized MF cones occupied more canal space than size 30 standardized ones (p<0.05). 3. In canals prepared up to size 35 ProFile$^{(R)}$ of .04 taper, there was no significant difference in canal space occupation among non-standardized MF and F, size 35 standardized, and Dia-Pro ISO-.04$^{TM}$ cones (p>0.05). 4. In canals prepared up to size 25 ProFile$^{(R)}$ of .06 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$, or size 25 standardized ones (p<0.05), and Dia-Pro ISO-.06$^{TM}$, cones occupied significantly more space than size 25 standardized ones (p<0.05). 5. In canals prepared up to size 30 ProFile$^{(R)}$ of .06 taper, non-standardized FM cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized F cones occupied significantly more canal space than size 30 standardized ones (p<0.05). 6. In canals prepared up to size 35 ProFile$^{(R)}$ of .06 taper, non-standardized M and FM, Dia-Pro ISO-.06$^{TM}$ occupied significantly more canal space than size 35 standardized ones (p<0.05). In summary, in both canals prepared with .04 or .06 taper ProFile$^{(R)}$, non-standardized cones showed better fitness than Dia-Pro ISO$^{TM}$ or standardized ones, which was more characteristic in smaller canals.

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Acute Respiratory Distress Syndrome in Respiratory Intensive Care Unit (호흡기계 중환자실에서 치료 관리된 급성호흡곤란증후군의 임상특성)

  • Moon, Seung-Hyug;Song, Sang-Hoon;Jung, Ho-Seuk;Yeun, Dong-Jin;Uh, Su-Tack;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1252-1264
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    • 1998
  • Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

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A Study on the Preservation of Citrus Mandarin by Irradiation (방사선조사(放射線照射)에 의(依)한 감귤(柑橘) 저장(貯藏)에 관(關)한 연구(硏究))

  • Chung, Chang Cho;Kim, Jai Ha;Kim, Soo Hyun;Cho, Han Ok
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.12 no.2
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    • pp.116-121
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    • 1983
  • A study was conducted to evaluate the effect of $^{60}CO-{\gamma}$ irradiation on the preservation on Satauma mandarin in Cheju Island. Four varieties (S. m. early, S. m. Komezawa, S. m. Hayashi and S. m. Aoshima) were irradiated using 10,000Ci, $^{60}CO-{\gamma}$ ray with dosages of 0, 50, 100 and 150Krad. During 92 days of storage the effects of irradiation on mandarin porperties were as follows: At the end of storage period the accumulated fruit rotting percentage were S. m. Komezawa($T_2$);74.32%, S. m. early($T_1$);69.67%, S. m. Aoshima($T_4$);64.33% and S. m. Hayashi ($T_3$);61.79%. The rottings steadily increased from the early stage of storage and rapid spoilage continued after 59 days of irradiation. A high corelation existed between fruit rotting and varieties ($T_3$;Y=0.78x-15.30, $T_4$;Y=0.79x-12.29, $T_1$;Y=0.93x-9.01 and $T_2$;Y=0.79x-13.49) High dosages(100 and 150 Krad)improved fruit preservation during the mid storage stage. However 76 days after high dose irradiation there was no significant difference a rotting between irradiated fruit and the control. Irradiation decreased acidity of fruit during storage (p<0.01). The mean acidities of examined varieties were $T_1$;1.01%, $T_3$;1.01%, $T_4$;0.84% and $T_2$;0.77%. A significant differences were observed in acidity between varieties and dosages(P<0.01) With one exception in all treatments. the increase in free and total sugar content was not statestically significant. The exception was the 50 Krad treatment where the total sugar content decreased. $T_1$ and $T_4$ showed slightly higher value of than Brix $T_2$ and $T_3$, and were significantly(P<0.01) decreased by higher dosage. The ascorbic acid content in all treatments decreased with length of storage and also decreased significantly with a higher dosage.

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Studies on Stability for the Quality of Ginseng Products -5. Improvement of Physical Properties on Moisture Sorption of Spray Dried Red Ginseng Extract Powder- (인삼제품(人蔘製品)의 품질안정성(品質安定性)에 관한 연구(硏究) -5. 홍삼정분(紅蔘精粉)의 흡습물성(吸濕物性) 개선(改善)-)

  • Choi, Jin-Ho;Byun, Dae-Seok;Ro, Jae-Il;Park, Kil-Dong;Sung, Hyun-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.13 no.3
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    • pp.251-258
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    • 1984
  • In order to improve the physical properties on moisture sorption of spray dried red ginseng extract powder (SD-RGEP), the various additives and coating agents were treated, and solubility, sedimentation rate and storage stability of RGEPs treated were investigated. For the moisture-proofing, additive itself was effective in the order casein>dextrin>starch>avicell, but RGEPs treated with additives were effective in the order cord oil+tween-40>starch>casein. But there was no significant difference between RGEP treated less than 1% additive and the moisture-proofing. The coating effect of AEA and CAP on RGEP could not be recognized for the moisture-proofing, whereas that of HPC, corn oil, lecithin and HPC+corn oil was proved to be very effective for the moisture-proofing of RGEP. Also it is required to control the initial moisture content of RGEP. The sedimentation rate of RGEP nontreated was 65.1 seconds, whereas that of RGEPs coated with 1% HPC, 1% corn oil, 1% lecithin and 1% HPC+0.5% corn oil was in the range of 96.2 to 114.3 seconds. The sedimentation rate of RGEPs coated was 1.5 to 1.8 times higher than that of RGEP nontreated, and there was significant difference between solubility and sedimentation rate. Therefore it was no matter for the keeping quality. The sorption rates of RGEPs coated with lecithin $(0.5{\sim}1.0%$), corn oil(0.8%) and cellulose acetate (0.8%) were ranged 54 to 56%, 51 to 55% and 52 to 54%, respectively, and it is found that the moisture-proofing effect of RGEPs coated was about 2 times higher than that of RGEP nontreated. From the result of storage experiment during 3 months under the maltreated condition of $48{\pm}2^{\circ}C$, 75% RH, the moisture sorption of RGEPs coated with corn oil$(0.5{\sim}1.0%$), cellulose acetate(DES, $0.5{\sim}0.8%$) and lecithin (DES, 1.0%) was not at all observed. Therefore it is considered that the circulating period of RGEPs coated with these coating agents could to give more than 3 years.

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Protoplast Fusion of Nicotiana glauca and Solanum tuberosum Using Selectable Marker Genes (표식유전자를 이용한 담배와 감자의 원형질체 융합)

  • Park, Tae-Eun;Chung, Hae-Joun
    • The Journal of Natural Sciences
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    • v.4
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    • pp.103-142
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    • 1991
  • These studies were carried out to select somatic hybrid using selectable marker genes of Nicotiana glauca transformed by NPTII gene and Solanum tuberosum transformed by T- DNA, and to study characteristics of transformant. The results are summarized as follows. 1. Crown gall tumors and hairy roots were formed on potato tuber disc infected by A. tumefaciens Ach5 and A. rhizogenes ATCC15834. These tumors and roots could be grown on the phytohormone free media. 2. Callus formation from hairy root was prompted on the medium containing 2, 4 D 2mg/I with casein hydrolysate lg/l. 3. The survival ratio of crown gall tumor callus derived from potato increased on the medium containing the activated charcoal 0. 5-2. 0mg/I because of the preventions on the other hand, hairy roots were necrosis on the same medium. 4. Callus derived from hairy root were excellently grown for a short time by suspension culture on liquid medium containing 2, 4-D 2mg/I and casein hydrolysate lg/l. 5. The binary vector pGA643 was mobilized from E. coli MC1000 into wild type Agrobacteriurn tumefaciens Ach5, A. tumefaciens $A_4T$ and disarmed A. tuniefaciens LBA4404 using a triparental mating method with E. ccli HB1O1/pRK2013. Transconjugants were obtained on the minimal media containing tetracycline and kanamycin. pGA643 vectors were confirmed by electrophoresis on 0.7% agarose gel. 6. Kanamycin resistant calli were selected on the media supplemented with 2, 4-D 0.5mg/1 and kanamycin $100\mug$/ml after co- cultivating with tobacco stem explants and A. tumefaciens LBA4404/pGA643, and selected calli propagated on the same medium. 7. The multiple shoots were regenerated from kanamycin resistant calli on the MS medium containing BA 2mg/l. 8. Leaf segments of transformed shoot were able to grow vigorusly on the medium supplemented with high concentration of kanamycin $1000\mug$/ml. 9. Kanamycin resistant shoots were rooting and elongated on medium containing kanamycin $100\mug$/ml, but normal shoot were not. 10. For the production of protoplast from potato calli transformed by T-DNA and mesophyll tissue transformed by NPTII gene, the former was isolated in the enzyme mixture of 2.0% celluase Onozuka R-10, 1.0% dricelase, 1.0% macerozyme. and 0.5M mannitol, the latter was isolated in the enzyme mixture 1.0% Celluase Onozuka R-10, 0.3% macerozyme, and 0.7M mannitol. 11. The optimal concentrationn of mannitol in the enzyme mixture for high protoplast yield was 0.8M at both transformed tobacco mesophyll and potato callus. The viabilities of protoplast were shown above 90%, respectively. 12. Both tobacco mesophyll and potato callus protoplasts were fused by using PEG solution. Cell walls were regenerated on hormone free media supplemented with kanamycin after 5 days, and colonies were observed after 4 weeks culture.

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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