• Journal of the Korean Applied Science and Technology
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• v.18 no.3
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• pp.197-213
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• 2001

Conjugate trienoic acids (CTA) occurred in triacylglycerols (TGs) of the seed oils of Trichosanthes kirilowii, Momordica charantia and Aleurites fordii, and they were easily converted to their methyl esters in a mixture of sodium methoxide-methanol without any structural destruction. The main fatty acids in triacylglycerol (TG) fraction of the seed oils of Trichosanthes kirilowii are $C_{18:2{\omega}6}$ (32.2 mol %), $C_{18:3{\;}9c.11t,13c}$ (38.0 mol %) and $C_{18:1{\omega}9}$ (11.8 mol %), followed with $C_{16:0}$ (4.8 mol %) and $C_{18:0}$ (3.1 mol %). The TG fraction was resolved into 20 TG molecular species according to the partition number (PN) by reversed-phase (RP)-HPLC. The main TG species were $DT_{c2}$, $MDT_{c}$ and $D_{2}T_{c}$, of which amounts reached 63 mol % of total TG molecular species. The TG sample was fractionated into 11 fractions according to the number of double bond in the molecule by $Ag^{+}-HPLC$ and the species of $DT_{c2}$, $MDT_{c}$ and $D_{2}T_{c}$ were also eluted as main components. The TG species containing CTA showed unusual behaviours in the order of elution by HPLC ; first, TG moleular species of $DT_{c2}$ (D; dienoic acid, $T_{c}$; punicic acid, $T_{ci}$; ${\alpha}-eleostearic$ acid, M ; monoenoic acid, $S_{t}$; stearic acid) was eluted earlier than $Mt_{c2}$, although they have the same PN number of 40, and, secondly, the species of $DT_{ci2}$ with eight double bonds was eluted earlier than that of $D_2T_{ci}$ with seven double bonds. Intact TG of the seed oils of Momordica charantia contained mainly fatty acids such as $C_{18:3{\omega}9c,11t,13t}$ (57.7 mol %), $C_{18:1{\omega}9}$ (17.4 mol %), $C_{18:0}$ (12.3 mol %) and $C_{18:2{\omega}6}$ (10.6 mol %), and was classified into 13 fractions by RP-HPLC. The main TG species were as follows ; $MT_{ci2}$ [$(C_{18:1{\omega}9})(C_{18:3\;9c,11t,13t})_{2}$, 39.1 mol %] and $S_{t}T_{ci2}$ [$(C_{18:0})(C_{18:3\;9c,11t,13t})_2$, 33.9 mol %] comprising about 73 mol % of total TG species, accompanied by $DT_{ci2}$ [$(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13t})_{2}$, 7.3 mol %], $D_{2}T_{ci}$ [$ (C_{18:2{\omega}6})_{2}(C_{18:3\;9c,11t,13t})$, 3.6 mol %] and $MDT_{ci}$ [$(C_{18:1{\omega}9})(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13t})$, 3.5 mol %]. Simple TG species of $T_{ci3}$ [$(C_{18:3\;9c,11t,13t})_3]$ was present in a small amount of 1.4 mol %, but other simple TG species were not detected. The TG was also resolved into 11 fractions according to the number of double bond by $Ag^{+}-HPLC$, and the species were mainly occupied by $MT_{ci2}$ [$(C_{18:1{\omega}9})(C_{18:3\;9c,11t,13t})_{2}$, 39.4 mol %] and $S_tT-{ci2}$ [$(C_{18:0})(C_{18:3\;9c,11t,13t})_{2}$, 35.4 mol %] $DT_{ci2}$ species with eight double bonds was also developed faster than $D_2T_{ci}$ one with seven double bonds as indicated in the analysis of TG of the seed oils of T. kirilowii, and $MT_{ci2}$ species with cis, trans, trans-configurated double bond was eluted earlier than $MT_{c2}$ species with cis, trans, cis-configurated double bond. The main components of fatty acid in total TG fraction isolated from the seed oils of of Aleurites fordii were in the following order ; $C_{18:3\;9c,11t,13t}$ (81.2 mol %)> $C_{18:2{\omega}6}$ (8.5 mol %)> $C_{18:1{\omega}9}$ (5.4 mol %)$. With resolution of the TG by RP-HPLC, eight fractions such as $T_{ci3}$, $Dt_{ci2}$, $D_{2}T_{ci}$, $MT_{ci2}$, $PT_{ci2}$ (P; palmitic acid), $PMT_{ci}$, $PDT_{ci}$ and $S_{t}T_{ci2}$ ($S_{t}$; stearic acid) were isolated, respectively. TG species of $T_{ci3}$ [$(C_{18:3\;9c,11t,13t})_{3}$, 54.2 mol %], $DT_{ci2}$ [$(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13t})_{2}$, 15.0 mol %] and $MT_{ci2}$ [$(C_{18:1{\omega}9})(C_{18:3 9c,11t,13t})_{2}$, 14.8 mol %] were present as main species.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.1
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• pp.96-101
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• 2003

This study was done to analyze the contents of minerals, to compare the measured values of calcium and the labeled values in food labeling and to analyze the ratio of calcium to other minerals in 43 calcium-fortified Food products sold in markets in Seoul, Korea. Content of minerals such as Ca, P, Mg, Na, K, Fe, Cu, Zn was measured by atomic absorption or colorimetric method after dry-ashing or wet-ashing. The measured values of calcium were ranged 65.5~343.9% of the labeled values in 43 calcium-fortified products. In 21 calcium-fortified food products, the measured calcium values were ranged 120～160% of the labeled values, and in three drinks those were less than 80% of the labeled, which is not acceptable to the food regulation. The ratios of Ca:P were 2.63$\pm$1.99 (mean$\pm$SD) in grain Products, 1.79$\pm$0.39 in Ramyuns, 2.80$\pm$0.53 in retort pouch food products and 8.35$\pm$12.87 in drinks. The Ca:Fe ratios were 126.33$\pm$44.36 in grain products, 130.65$\pm$34.67 in Ramyuns, 120.31$\pm$71.15 in retort pouch food products and 700.25$\pm$553.70 in drinks. The ratios of Ca:Mg were 11.86$\pm$5.40 in grain products, 9.29$\pm$1.34 in Ramyuns, 9.09$\pm$2.09 in retort pouch food products and 32.50$\pm$41.35 in drinks. The P:Mg ratios were 4.11$\pm$1.54 in grain products, 4.17$\pm$0.67 in Ramyuns, 2.58$\pm$0.45 in retort pouch food Products and 2.59$\pm$2.50 in drinks. These results suggest calcium contents and the ratio of calcium contents to other minerals in calcium-fortified food products should be strictly controlled.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.8
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• pp.1408-1413
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• 2003

This study was conducted to analyze manganese contents of Korean common foods. Contents of manganese in 30 foods were analyzed by ICP spectrometer. And daily manganese intake through 30 common foods was calculated using analysis data of this study and daily food intakes cited from report on 1998 national health and nutrition survey. The average manganese contents of foods analyzed were 949.6 $\mu\textrm{g}$ for rice, 236.1 $\mu\textrm{g}$ for Korean chinese cabbage kimchi, 27.2 $\mu\textrm{g}$ for citrus fruit, 2.6 $\mu\textrm{g}$ for milk, 214.6 $\mu\textrm{g}$ for radish root, 40.0 $\mu\textrm{g}$ for apple, 60.4 $\mu\textrm{g}$ for persimmon, 13.9 $\mu\textrm{g}$ for pork, 9.5 $\mu\textrm{g}$ for beef, 638.3 $\mu\textrm{g}$ for soybean curd, 184.0 $\mu\textrm{g}$ for radish kimchi, 56.0 $\mu\textrm{g}$ for pear, 18.4 $\mu\textrm{g}$ for beer, 11.3 $\mu\textrm{g}$ for egg, 9.5 $\mu\textrm{g}$ for carbonated beverage, 345.0 $\mu\textrm{g}$ for bread, 50.7 $\mu\textrm{g}$ for soju, 270.3 $\mu\textrm{g}$ for potato, 236.1 $\mu\textrm{g}$ for sweet potato, 91.2 $\mu\textrm{g}$ for ramyeon, 32.5 $\mu\textrm{g}$ for onion, 68.0 $\mu\textrm{g}$ for nabak kimchi, 538.2 $\mu\textrm{g}$ for soybean sprout, 112.5 $\mu\textrm{g}$ for welsh onion, 336.7 $\mu\textrm{g}$ for rice cake, 589.9 $\mu\textrm{g}$ for Korean chinese cabbage, 430.4 $\mu\textrm{g}$ for somyeon, 144.3 $\mu\textrm{g}$ for pumpkin, 3.0 $\mu\textrm{g}$ for yoghurt, and 614.4 $\mu\textrm{g}$ for spinach per 100 g of each food. The daily manganese intake through 30 common foods of Koreans in 1998 was 3420.7 $\mu\textrm{g}$. Major sources of dietary manganese were rice, kimchi, and soybean curd. Especially, rice supplied 68.1% of total dietary manganese intake through 30 common foods. Further studies are required to establish database and RDA of manganese.

• Journal of Korean Society of Forest Science
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• v.43 no.1
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• pp.20-30
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• 1979

The purpose of present study is to analyze the genetic variation of natural stand of Pinus densiflora. In 1976 following after the seletion of 1974 and 1975, twenty trees from each of three natural populations of the species were selected and seeds were collected, and the locations and conditions of populations are presented in table 1, 2 and figure 1. Some morphological traits of the populations were already detailed in our fifth report of this series. The morphological traits of cone, seed and seed-wing, and also the growth performances and needle characters of the seedling were observed in the present study according to the previous methods. The results obtained are summarized as follows; 1. The meteorological data obtained by averaging the records of 30 year period(1931~1960) measured from the nearest meteorological station to each population are shown in fig. 2, 3, 4. The distributional patterns of investigated climate factors are generally considered to be similar among the locations. However, the precipitation density during growing season and the air temperature during dormant season on Samchuk area (Pop. 9) were quite different from those of the other areas. 2. The measurements of fresh cone weight, length, diameter and cone index (i.e.: length to diameter ratio) are presented in table 7. As shown in table 7, all these traits except for cone diameter seem to be not significant in population and to be highly significant in family differences within population. 3. The morohological traits of seed and seed-wing are detailed in table 8, 9, and highly significant differences are recognized among the populations and the families within population in seed weight, seed length, seed thickness but not among the populations in the other observed traits. The values of correlation between the characteristics of cone and seed are presented in table 12. As shown, the correlation between cone length and seed wing length, between seed wing width and seed width were significantly positive in population 8 and 9 but in population 7. The positive correlations between seed length and seed width were calculated in all populations studied 4. Significant statistical differences among populations and families within population are observed in the growth performances of 1-0 seedling height of these progenies. But the differences in 1-1 seedling height and root collar diameter are shown only among familes within population. As shown in table 13, the most parts of correlations are not significant statistically between the growth performances of seedling and the seed characters. 5. As shown in table 15, statistical differences are considered to be significant among the populations in stomata row on both sides of the needle but not in serration density. The correlations between progenies and parents are not generally observed in the investigated traits of needle as shown in table 16.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.10
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• pp.1293-1299
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• 2007

This study was performed to assess the nutritional status of the elderly residing in a silver town. A survey was conducted in April, 2005 for fifty two healthy persons (men 18, women 34) aged over 65 years living in a private silver town of Busan Metropolitan City, Korea. General data were collected using questionnaires at homes of the subjects and food consumption data for 3 days were obtained by investigating the individual leftovers from the meals served at the foodservice facilities by well-trained graduate students of the Department of Food & Nutrition. Nutrient intake was calculated from food consumption data using Can Pro (version 3.0, Korea). Average daily intake of energy was 1077.6 kcal in men and 974.2 kcal in women. Average protein intake of the men and women amounted to 85.5 g and 67.7 g, respectively. The consumption of cereals contributed 45.3% of energy intake for all subjects. Only 1.1% of calcium intake was from milk and milk products. Almost 100% of the elderly did not reach 75% of estimated energy requirement (EER) in energy intake and 75% of estimated average requirement (EAR) in folic acid intake. Percentages of the subjects who consumed protein above 125% of EAR were 100% and 91% in men and women, respectively. All subjects consumed above EAR in dietary intake of protein and iron. These data suggest that nutrient intake of the elderly living in the silver town would be inadequate, and thus the efficient management of foodservice is necessary to improve the nutritional status of the elderly living in the silver town.

• Journal of the Korean Society of Food Science and Nutrition
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• v.40 no.9
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• pp.1244-1255
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• 2011

The purpose of this study was to compare the perception of meals and nutrition knowledge among high school students in Seoul. A survey was carried out on 548 male/female students in general and vocational high schools. The general high school students showed higher frequency of breakfast than the vocational high school students (p<0.001). As for the reasons for eating alone, the general high school students showed high frequency of 'busy', whereas the vocational high school students revealed high frequency of 'irregular meal times' (p<0.001). Concerning the habit of eating alone, 'irregular meal times (25.0%)', 'unbalanced diet (22.4%)', and 'instant food (16.6%)' were observed in that order (p<0.01). The percentage of high school students who regarded family meals as meals eaten with every member of their family was 70.6% (p<0.05). The percentage of general high school students who ate family meals was 61.8% and that of vocational high school students was 50.0% (p<0.01). When agreement with attitudes, environment, and participation in family meals was evaluated using a Likert scale (strongly agree 5 points, strongly disagree 1 point), the general high school students showed a higher level of agreement than the vocational high school students, and the results showed a significantly higher level of agreement as the frequency of family meals increased. Likewise, the groups who scored a higher level of nutrition knowledge had positive attitudes, environment, and participation in family meals with significant differences.

• Journal of Korean Academy of Nursing
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• v.11 no.1
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• pp.65-87
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• 1981

The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1％ indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0％ of the respondents view that patient is the client, while only 67.1％ of nursing student and 74.7％ of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6％ satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9％ were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l％ were not have any religion; 52.6% were unmarried； 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p ＜ 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96％ of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.736-745
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• 1998

Background: Respiratory muscle interaction is further profoundly affected by a number of pathologic conditions. Hyperinflation may be particularly severe in chronic obstructive pulmonary disease(COPD) patients, in whom the functional residual capacity(FRC) often exceeds predicted total lung capacity(TLC). Hyperinflation reduces the diaphragmatic effectiveness as a pressure generator and reduces diaphragmatic contribution to chest wall motion. Ultrasonography has recently been shown to be a sensitive and reproducible method of assessing diaphragmatic excursion. This study was performed to evaluate how differences of diaphragmatic excursion measured by ultrasonography associate with normal subjects and COPD patients. Methods: We measured diaphragmatic excursions with ultrasonography on 28 healthy subjects(l6 medical students, 12 age-matched control) and 17 COPD patients. Ultrasonographic measurements were performed during tidal breathing and maximal respiratory efforts approximating vital capacity breathing using Aloka KEC-620 with 3.5 MHz transducer. Measurements were taken in the supine posture. The ultrasonographic probe was positioned transversely in the midclavicular line below the right subcostal margin. After detecting the right hemidiaphragm in the B-mode the ultrasound beam was then positioned so that it was approximately parallel to the movement of middle or posterior third of right diaphragm. Recordings in the M-mode at this position were made throughout the test. Measurements of diaphragmatic excursion on M-mode tracing were calculated by the average gap in 3 times-respiration cycle. Pulmonary function test(SensorMedics 2800), maximal inspiratory(PImax) and expiratory mouth pressure(PEmax, Vitalopower KH-101, Chest) were measured in the seated posture. Results: During the tidal breathing, diaphragmatic excursions were recorded $1.5{\pm}0.5cm$, $1.7{\pm}0.5cm$ and $1.5{\pm}0.6cm$ in medical students, age-matched control group and COPD patients, respectively. Diaphragm excursions during maximal respiratory efforts were significantly decreased in COPD patients ($3.7{\pm}1.3cm$) when compared with medical students, age-matched control group($6.7{\pm}1.3cm$, $5.8{\pm}1.2cm$, p< 0.05}. During maximal respiratory efforts in control subjects, diaphragm excursions were correlated with $FEV_1$, FEVl/FVC, PEF, PIF, and height. In COPD patients, diaphragm excursions during maximal respiratory efforts were correlated with PEmax(maximal expiratory pressure), age, and %FVC. In multiple regression analysis, the combination of PEmax and age was an independent marker of diaphragm excursions during maximal respiratory efforts with COPD patients. Conclusion: COPD subjects had smaller diaphragmatic excursions during maximal respiratory efforts than control subjects. During maximal respiratory efforts in COPD patients, diaphragm excursions were well correlated with PEmax. These results suggest that diaphragm excursions during maximal respiratory efforts with COPD patients may be valuable at predicting the pulmonary function.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.367-376
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• 1996

Background : The diagnosis of emphysema during life is based on a combination of clinical, functional, and radiographic findings, but this combination is relatively insensitive and nonspecific. The development of rapid, high-resolution third and fourth generation CT scanners has enabled us to resolve pulmonary parenchymal abnormalities with great precision. We compared the chest HRCT findings to the pulmonary function test and arterial blood gas analysis in pulmonary emphysema patients to test the ability of HRCT to quantify the degree of pulmonary emphysema. Methods : From october 1994 to october 1995, the study group consisted of 20 subjects in whom HRCT of the thorax and pulmonary function studies had been obtained at St. Mary's hospital. The analysis was from scans at preselected anatomic levels and incorporated both lungs. On each HRCT slice the lung parenchyma was assessed for two aspects of emphysema: severity and extent. The five levels were graded and scored separately for the left and right lung giving a total of 10 lung fields. A combination of severity and extent gave the degree of emphysema. We compared the HRCT quantitation of emphysema, pulmonary function tests, ABGA, CBC, and patients characteristics(age, sex, height, weight, smoking amounts etc.) in 20 patients. Results : 1) There was a significant inverse correlation between HRCT scores for emphysema and percentage predicted values of DLco(r = -0.68, p < 0.05), DLco/VA(r = -0.49, p < 0.05), FEV1(r = -0.53, p < 0.05), and FVC(r = -0.47, p < 0.05). 2) There was a significant correlation between the HRCT scores and percentage predicted values of TLC(r = 0.50, p < 0.05), RV(r = 0.64, p < 0.05). 3) There was a significant inverse correlation between the HRCT scores and PaO2(r = -0.48, p < 0.05) and significant correlation with D(A-a)O2(r = -0.48, p < 0.05) but no significant correlation between the HRCT scores and PaCO2. 4) There was no significant correlation between the HRCT scores and age, sex, height, weight, smoking amounts in patients, hemoglobin, hematocrit, and wbc counts. Conclusion : High-Resolution CT provides a useful method for early detection and quantitating emphysema in life and correlates significantly with pulmonary function tests and arterial blood gas analysis.

• 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.