• Title/Summary/Keyword: 호흡기계질환

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Clinicopathologic features of Acute Interstitial Pneumonia (급성 간질성 폐렴의 임상적 고찰)

  • Shim, Jae-Jeong;Park, Sang-Muyn;Lee, Sang-Hwa;Lee, Jin-Gu;Cho, Jae-Yun;Song, Gwan-Gyu;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.58-66
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    • 1995
  • Background: Acute interstitial pneumonia is a relatively rare form of interstitial pneumonia, since the vast majority of interstitial pneumonia have a more chronic course. It corresponds to the lesion described by Hamman and Rich, as Hamman-Rich disease in 1944. Another name in the clinical literature is accelerated interstitial pneumonia, idiopathic acute respiratory distress syndrome (idiopathic ARDS), and the organizing stage of diffuse alveolar damage. Acute interstitial pneumonia differs from chronic interstitial pneumonia by clinical and pathologic features. Clinically, this disease is characterized by a sudden onset and a rapid course, and reversible disease. Method and Purpose: Five cases of pathologically proven acute interstitial pneumonia were retrospectively studied to define the clinical, radiologic, and pathologic features. Results: 1) The five cases ranged in age from 31 to 77 years old. The onset of illness was acute in all patients, it began with viral-like prodrome 6~40 days prior to shortness of breath, and respiratory failure eventually developed in all patients. In 2 cases, generalized skin rash was accompanied with flu-like symptoms. Etiologic agent could not be identified in any case. 2) All patients had leukocytosis and severe hypoxemia. Pulmonary function test of 3 available cases shows restrictive ventilatory defect, and one survived patient(case 5) has a complete improvement of pulmonary function after dismissal. 3) Diffuse bilateral chest infiltrates were present radiologically. Theses were the ground-glass, consolidation, and reticular densities without honeycomb fibrosis in all patients. The pathologic abnormalities were the presence of increased numbers of macrophages and the formation of hyaline membranes within alveolar spaces. There was also interstitial thickening with edema, proliferation of immature fibroblast, and hyperplasia of type II pneumocyte. In the survived patient(case5), pathologic findings were relatively early stage of acute interstitial pneumonia, such as hyaline membrane with mild interstitial fibrosis. 4) Of the 5 patients, four patients died of respiratory failure 14~90 days after onset of first symptom, and one survived and recovered in symptoms, chest X ray, and pulmonary function test Conclusion: These results emphasize that acute interstitial pneumonia is clinically, radiologically, and pathologically distinct form of interstitial pneumonia and should be separated from the group of chronic interstitial pneumonia. Further studies will be needed to evaluate the pathogenesis and the treatment of acute interstitial pneumonia.

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The Effects of Diesel Exhaust Particles on the Alveolar Macrophages for Inducible Nitric Oxide Synthase Induction and Nitric Oxide with Nitrotyrosilated-protein Formation (디젤분진이 폐포대식세포에서 nitric oxide의 생성과 inducible nitric oxide synthase의 발현 및 nitrotyrosilated-protein의 형성에 미치는 효과)

  • Lim Young;Choe Myung-Ok;Lee Kweon-Haeng;Kim Kyung-A;Kim Kil-Soo;Lee Myoung-Heon;Li Tian-Zhu;Lee Soo-Jin;Choe Nong-Hoon
    • Journal of Life Science
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    • v.16 no.2 s.75
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    • pp.192-198
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    • 2006
  • Epidemiological studies have demonstrated an association between exposure to diesel exhaust particles (DEP) and adverse cardiopulmonary effects. Despite the epidemiological proof, the pathogenesis of DEP-related pulmonary diseases remain poorly understood. So, comprehensive in vivo and in vitro researches are required to know the effects of DEP on diverse lung diseases. Alveolar macrophages (AM) and airway epithelial cells are known as important cellular targets in DEP-induced lung diseases. Other studies have shown that nitric oxide (NO) is involved in particle matter induced lung injury. The present study was undertaken to determine whether DEP has an synergistic effects on lipopolysaccharide (LPS)-induced NO formation and inducible nitric oxide synthase (iNOS) with nitrotyrosilated-protein formation in cultured primary alveolar macrophages. The formation of NO was determined through the Griess reaction in the cultured medium and iNOS with nitrotyrosilated-proteins are analyzed by immunohistochemical staining and Western analysis. The results indicate that DEP exposure does not induce NO formation by itself, however DEP showed significant synergistic effects on LPS-induced NO formation. So, our results suggest that DEP inhalation could aggravate inflammatory lung disease through NO formation.

Clinical Usefulness of Preoperative Levels of Leukocyte and D-Dimer in Predicting Perioperative Outcomes of Cardiovascular Disease (심혈관질환의 수술기주위 결과예측에 있어 수술 전 백혈구 수 및 D-dimer 농도의 임상적 유용성)

  • Choi, Seok-Cheol;Kim, Yang-Weon;Hwang, Soo-Myung
    • Journal of Life Science
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    • v.20 no.10
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    • pp.1458-1467
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    • 2010
  • The present study was retrospectively designed to define whether preoperative levels of leukocytes and D-dimer are potentially useful factors in predicting perioperative outcomes of coronary heart disease (CHD). There was no relationship between preoperative leukocyte counts (Pre-OP leukocyte) and preoperative D-dimer levels (Pre-OP D-dimer). Pre-OP leukocyte counts each had positive correlation with cardiac troponin-I, creatine kinase-MB or C-reactive protein (cardiac markers) levels at preoperative and postoperative periods. Pre-OP D-dimer levels were positively associated with each cardiac marker at the same periods. Pre-OP leukocyte counts positively related with aspartate aminotransferase and alanine aminotransferase (liver markers), whereas Pre-OP D-dimer level positively or negatively correlated with bilirubin (liver marker), creatinine (renal marker) or glucose levels at preoperative and/or postoperative periods. Pre-OP leukocyte and Pre-OP D-dimer were inversely associated with Pre-OP high density lipoprotein cholesterol levels or left ventricular ejection fraction. Pre-OP leukocyte counts each had positive correlation operation duration and postoperative mechanical ventilation-time (PMVT), whereas Pre-OP D-dimer levels had positive relationship with PMVT, intensive care unit-staying period and hospitalization. The retrospective data suggest that Pre-OP leukocyte and Pre-OP D-dimer levels may be clinically useful factors for predicting perioperative outcomes in patients with CHD.

The Effects of PM10 on the Hospital Admission of Patients with Respiratory Disease in Seoul, Korea (서울지역 미세먼지가 호흡기계 질환으로 입원한 환자에 미치는 영향)

  • Pak, Hae-Yong;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.9 no.6
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    • pp.194-201
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    • 2019
  • This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002-2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.

Construction of Medical Episode Data using National Health Insurance Service Data (국민건강보험청구 자료를 이용한 진료에피소드 자료 구축)

  • Pak, Hae-Yong;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.9 no.9
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    • pp.195-200
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    • 2019
  • The purpose of this study is to analyze the characteristics of National Health Insurance claim data and to construct a pilot medical episode data considering it. In this study, the trends of respiratory disease (ICD10: J00-J99) cardiovascular disease (ICD10: I00-I99) from the day of onset of treatment to re-admission after admission were confirmed in Seoul, and the largest decrease was observed when the no-treatment period was 0 day. The data reduction rate when the no-treatment period is 0 day is judged to be due to the monthly separation claim of the health insurance claim data. Also, the result that there is a tendency of monthly separation request according to the type of medical treatment. Through this study, we constructed epidemic data for the pilot medical treatment considering the characteristics of the claim data of health insurance, and based on this, it can be used as a data processing method for calculating basic epidemiological information.

Effects of Respiratory Infectious Disease Simulation-based Education using Standardized Patient for Nursing Student's of the Knowledge, Clinical Nursing Competency (표준화환자를 이용한 호흡기감염 시뮬레이션 교육이 간호대학생의 지식, 임상수행능력에 미치는 효과)

  • Jung Hur;Yeong Ju Yoon
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.3
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    • pp.435-442
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    • 2023
  • The purpose of this study is to analyze the effects of simulation education using standardized patients on respiratory infectious disease knowledge and clinical performance of nursing students. A single-group before-and-after design for the nursing of infectious respiratory patients using standardized patients from March 2 to June 15, 2020, targeting 112 senior nursing students. Respiratory infectious disease education program 'knowledge of lung infectious diseases', 'hand washing', 'wearing a mask', 'encouraging patients and caregivers to wear masks', 'intravenous injection', '3-way injection', 'surgical aseptic technique', 'disinfecting medical devices' , 'contaminated linen management', 'infected person management manual', etc., and 10 educational tasks were performed, and consisted of lectures, technical training, simulation using standardized patients, and debriefing. After simulation education using standardized patients, students' knowledge and clinical performance skills on respiratory infectious diseases showed significant improvement, and it was expected that it could be used for various infection control practices.

Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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Ultrastructure of nasal cilia in children with recurrent or persistent respiratory diseases (반복 지속성 호흡기 질환 소아에서 비강 섬모의 미세구조 검사의 의의)

  • Shin, Su-A;Yang, Seung;Oh, Jae-Won;Lee, Ha-Baik;Park, Cheol-Eon;Kwan, Jung-Kyun
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.410-416
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    • 2006
  • Purpose : Ciliary abnormalities of the respiratory system usually accompany recurrent or persistent respiratory diseases such as paranasal sinusitis, bronchiectasis, rhinitis, and/or otitis media, since they cause certain derangements in ciliary cleaning activities. This disease is usually inherited by autosomal recessive trait, but may also be found to be acquired or transient in rare cases after heavy exposure to pollutants, cigarette smoking or severe infection. We performed this study in children with frequently recurrent or persistent respiratory diseases to clarify if the ciliary abnormalities are preceding factors. Methods : We enrolled 17 children with suspected respiratory ciliary abnormalities. The indications for evaluation of ciliary ultrastructure were recurrent or persistent respiratory infections. Children with immunologic abnormalities were excluded. From August 2000 to July 2003, we performed a biopsy on nasal mucosa and examined the structure of ciliary status by using an electron microscope. Results : Of the subjects, there were seven males and 10 females, aged 2 to 10 years. Out of the 17 subjects, 12 cases of chronic paranasal sinusitis, nine chronic coughs, nine frequent upper respiratory infections, seven cases of recurrent otitis media, four cases of recurrent pneumonia, and four cases of bronchial asthma were found. Out of the 17 cases on which histologic examinations were conducted, four cases showed pathologic findings, including one case of inner dynein arm defect, one of microtubular transposition, one of supernumerous tubules, and one singlet, respectively. Conclusion : It is essential for differential diagnosis and effective treatment to identify the abnormalities of ultrastructure of nasal cilia in children with symptoms of frequently recurrent or persistent respiratory diseases, if immunodeficiency or respiratory allergy could be excluded.

Vasodilatation effect of Kirenol isolated from Sigesbeckia pubescens (털진득찰에서 분리한 Kirenol의 혈관 이완효과)

  • Nam, Jung Hwan
    • Korean Journal of Plant Resources
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    • v.33 no.5
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    • pp.467-475
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    • 2020
  • The purpose of this study is to investigate the vasodilatation effect of kirenol isolated from Sigesbeckia pubescens on the rabbit basilar artery. In this study, to determine the vasodilatation effect of kirenol on the rabbit basilar artery, arterial rings with intact or damaged endothelium were used for the experiment. And used an organ bath and force transducer were contracted by endothelin. Kirenol, major active constituents of S. pubescens, showed a moderate vasodilatation effect on the basilar arteries of rabbits. Therefore, treatment with kirenol may selectively accelerate cerebral blood flow through dilatation of the basilar artery. This result suggests a potential role of kirenol isolated from S. pubescens as a source of vasodilatation agent.

Clinical Symptoms and Personality Characteristics on MMPI of Patients in Hwa-Byung Clinic (홧병클리닉을 방문한 환자들의 임상 증상과 MMPI 상의 성격 특징에 대한 연구)

  • Lee, Yu-Jin;Baek, Kyung-Won;Kim, Ha-Kyung;Yun, Kyu-Wol;Lim, Weon-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.120-124
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    • 2008
  • Objectives : The current study aimed at assessing clinical symptoms and personality characteristics on MMPI of patients in Hwa-Byung clinic. Methods : Thirty-one female patients($45.4{\pm}8.4$ years old) who visited to the Hwa-Byung Clinic in Ewha womans Dongdaemoon hospital were recruited. Semistructured interviews and laboratory tests for symptoms were performed for the patients group. Patients group and control group($42.9{\pm}8.0$ years old) completed MMPI. Results : All patients had symptoms of chest tightness or chest pain. 19(61.3%) out of 31 patients had gastrointestinal complaints. There were respiratory symptoms in 13(41.9%) patients. 12 patients(38.7%) suffered from difficulties in their sleep. 12 patients(38.7%) had psychiatric symptoms including anxiety or depressed mood. 8 patients(27.6%) were diagnosed as gastrointestinal diseases by the laboratory test. After controlling age and education, scores of Hs, D, Hy, Pt on MMPI in patients group were significantly higher than control group (p=0.001, p=0.049, p=0.000, and p=0.029, ANCOVA, respectively). Conclusion : In the current study, patients who have visited Hwa-Byung clinic showed various somatic symptoms including chest tightness, gastrointestinal symptoms, complaints in respiratory system and psychiatric symptoms. Based on laboratory tests, considerable proportion of patients was diagnosed as physical illnesses. Additionally, patients in Hwa-Byung clinic have a tendency to be more hypochondriatic, depressed, hysteric and anxious.

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