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Dose verification for Gated Volumetric Modulated Arc Therapy according to Respiratory period (호흡연동 용적변조 회전방사선치료에서 호흡주기에 따른 선량전달 정확성 검증)

  • Jeon, Soo Dong;Bae, Sun Myung;Yoon, In Ha;Kang, Tae Young;Baek, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.137-147
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    • 2014
  • Purpose : The purpose of this study is to verify the accuracy of dose delivery according to the patient's breathing cycle in Gated Volumetric Modulated Arc Therapy Materials and Methods : TrueBeam STxTM(Varian Medical System, Palo Alto, CA) was used in this experiment. The Computed tomography(CT) images that were acquired with RANDO Phantom(Alderson Research Laboratories Inc. Stamford. CT, USA), using Computerized treatment planning system(Eclipse 10.0, Varian, USA), were used to create VMAT plans using 10MV FFF with 1500 cGy/fx (case 1, 2, 3) and 220 cGy/fx(case 4, 5, 6) of doserate of 1200 MU/min. The regular respiratory period of 1.5, 2.5, 3.5 and 4.5 sec and the patients respiratory period of 2.2 and 3.5 sec were reproduced with the $QUASAR^{TM}$ Respiratory Motion Phantom(Modus Medical Devices Inc), and it was set up to deliver radiation at the phase mode between the ranges of 30 to 70%. The results were measured at respective respiratory conditions by a 2-Dimensional ion chamber array detector(I'mRT Matrixx, IBA Dosimetry, Germany) and a MultiCube Phantom(IBA Dosimetry, Germany), and the Gamma pass rate(3 mm, 3%) were compared by the IMRT analysis program(OmniPro I'mRT system software Version 1.7b, IBA Dosimetry, Germany) Results : The gamma pass rates of Case 1, 2, 3, 4, 5 and 6 were the results of 100.0, 97.6, 98.1, 96.3, 93.0, 94.8% at a regular respiratory period of 1.5 sec and 98.8, 99.5, 97.5, 99.5, 98.3, 99.6% at 2.5 sec, 99.6, 96.6, 97.5, 99.2, 97.8, 99.1% at 3.5 sec and 99.4, 96.3, 97.2, 99.0, 98.0, 99.3% at 4.5 sec, respectively. When a patient's respiration was reproduced, 97.7, 95.4, 96.2, 98.9, 96.2, 98.4% at average respiratory period of 2.2 sec, and 97.3, 97.5, 96.8, 100.0, 99.3, 99.8% at 3.5 sec, respectively. Conclusion : The experiment showed clinically reliable results of a Gamma pass rate of 95% or more when 2.5 sec or more of a regular breathing period and the patient's breathing were reproduced. While it showed the results of 93.0% and 94.8% at a regular breathing period of 1.5 sec of Case 5 and 6, it could be confirmed that the accurate dose delivery could be possible on the most respiratory conditions because based on the results of 100 patients's respiratory period analysis as no one sustained a respiration of 1.5 sec. But, pretreatment dose verification should be precede because we can't exclude the possibility of error occurrence due to extremely short respiratory period, also a training at the simulation and careful monitoring are necessary for a patient to maintain stable breathing. Consequently, more reliable and accurate treatments can be administered.

Study on 3D Printer Suitable for Character Merchandise Production Training (캐릭터 상품 제작 교육에 적합한 3D프린터 연구)

  • Kwon, Dong-Hyun
    • Cartoon and Animation Studies
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    • s.41
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    • pp.455-486
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    • 2015
  • The 3D printing technology, which started from the patent registration in 1986, was a technology that did not attract attention other than from some companies, due to the lack of awareness at the time. However, today, as expiring patents are appearing after the passage of 20 years, the price of 3D printers have decreased to the level of allowing purchase by individuals and the technology is attracting attention from industries, in addition to the general public, such as by naturally accepting 3D and to share 3D data, based on the generalization of online information exchange and improvement of computer performance. The production capability of 3D printers, which is based on digital data enabling digital transmission and revision and supplementation or production manufacturing not requiring molding, may provide a groundbreaking change to the process of manufacturing, and may attain the same effect in the character merchandise sector. Using a 3D printer is becoming a necessity in various figure merchandise productions which are in the forefront of the kidult culture that is recently gaining attention, and when predicting the demand by the industrial sites related to such character merchandise and when considering the more inexpensive price due to the expiration of patents and sharing of technology, expanding opportunities and sectors of employment and cultivating manpower that are able to engage in further creative work seems as a must, by introducing education courses cultivating manpower that can utilize 3D printers at the education field. However, there are limits in the information that can be obtained when seeking to introduce 3D printers in school education. Because the press or information media only mentions general information, such as the growth of the industrial size or prosperous future value of 3D printers, the research level of the academic world also remains at the level of organizing contents in an introductory level, such as by analyzing data on industrial size, analyzing the applicable scope in the industry, or introducing the printing technology. Such lack of information gives rise to problems at the education site. There would be no choice but to incur temporal and opportunity expenses, since the technology would only be able to be used after going through trials and errors, by first introducing the technology without examining the actual information, such as through comparing the strengths and weaknesses. In particular, if an expensive equipment introduced does not suit the features of school education, the loss costs would be significant. This research targeted general users without a technology-related basis, instead of specialists. By comparing the strengths and weaknesses and analyzing the problems and matters requiring notice upon use, pursuant to the representative technologies, instead of merely introducing the 3D printer technology as had been done previously, this research sought to explain the types of features that a 3D printer should have, in particular, when required in education relating to the development of figure merchandise as an optional cultural contents at cartoon-related departments, and sought to provide information that can be of practical help when seeking to provide education using 3D printers in the future. In the main body, the technologies were explained by making a classification based on a new perspective, such as the buttress method, types of materials, two-dimensional printing method, and three-dimensional printing method. The reason for selecting such different classification method was to easily allow mutual comparison of the practical problems upon use. In conclusion, the most suitable 3D printer was selected as the printer in the FDM method, which is comparatively cheap and requires low repair and maintenance cost and low materials expenses, although rather insufficient in the quality of outputs, and a recommendation was made, in addition, to select an entity that is supportive in providing technical support.

Processing of Water Activity Controlled Fish Meat Paste by Dielectric Heating 1. Formulation and Processing Conditions (내부가열을 이용한 보장성어육(고등어) 연제품의 가공 및 제품개발에 관한 연구 1. 원료${\cdot}$첨가물의 배합 및 가공조건)

  • LEE Kang-Ho;LEE Byeong-Ho;You Byeong-Jin;SUH Jae-Soo;JO Jin-Ho;JEONG In-Hak;JEA Yoi-Guan
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.17 no.5
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    • pp.353-360
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    • 1984
  • As an effort to expand the utilization of mackerel which has been thought disadvantageous to processors due to the defects in bloody dark color of meat, high content of lipid, and low stability of protein, and to develope a new type of product, so called, preservative fish meat paste, the processing method was studied in which dielectric heating was applied by means of cooking, pasteurization, dehydration, and control of water activity. The principle of this method is based on that dielectric heating can initiate a rapid dispersion or displacement of moisture in the meat tissue so that the level of water acivity can be controlled by dehydration with hot air meanwhile the product is cooked, pasteurized, and texturized. And the product is finally heated with electric heaters and vacuum sealed to stabilize water activity and storage stability. In present paper, a formula for preparing the fish meat-stach paste, the conditions of dielectric heating and dehydration, shape and size of the product, and other parameters were tested to optimize the process operation. A formula of the fish meat-starch paste to provide proper textural properties and water activity was $10\%$ starch, $1.5\%$ salt, $3\%$ soybean, $0.6\%$ MSG, $2\%$ sucrose, and $3\%$ sorbitol against the weight of fish meat. A proper shape and size of the product to avoid foaming and case hardening during heating was sliced disc of 8 cm $diameter{\times}0.8$ cm thickness or $10{\times}10$ cm square plate with 1.0 cm thickness. The disc shape was recommended because it resulted more uniform heating, minimum foaming and case hardening. And it was also advantageous that disc was simply provided when the fish meat disc was stuffed in the same, solidified in boiling water for 2 to 3 minutes, and sliced. Condition of dielectric heating was critical to decide the levels of sterility, water activity, and textural property of the product. The temperature at the center of the meat disc slices was raised up to $95^{\circ}C$ in 1.5 minutes so that continuous exposure to microwave caused expanded tissue and hardening ending up with a higher water content. Heating for 5 to 6 minutes was adequate to yield the final water activity of 0.86 to 0.83(35 to $40\%$ moisture). It is important, however, that heating had to be done periodically, for instance, in the manner of 2.0, 1.5, 1.5, and 1.0 minute to give enough time to displace or evaporate moisture from the meat tissue. The product was dehydrated for 2 to 3 minutes by hot air of $60^{\circ}C$, 3 to 5m/sec and finally exposed to electric heaters for 5 to 6 minutes until the surface was roasted deep brown. These conditions of heating and dehydration resulted in a complete reduction of total plate count from an initial count of $5.3{\times}10^6/g$ to less than $3{\times}10^2/g$. General composition of the product was $40.1\%$ moisture, $20.8\%$ protein, $17.4\%$ lipid, $16.2\%$ carbohydrate, and $5.5\%$ ash. Textural properties revealed folding test AA, hardness 42, cohesiveness 0.53, toughness 4.6, and elasticity 0.8.

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A Basic Study on Spatial Recognition through Poet in Soswaewon Garden (시문을 통해 본 소쇄원의 공간인식에 관한 기초연구)

  • Lee, Won-Ho;Kim, Dong-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.3
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    • pp.38-49
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    • 2015
  • This study aims to contemplated spatial recognition in Soswaewon Garden through garden visitors poetry. It was content analysis in poetry and extract frequency from words based on relationship of author. The results were as follows. First, relationship of authors who wrote Soswaewon Garden poetry was formed in companionship. In the Yang, San-Bo(梁山甫), poetry was written by Song, Soon(宋純), Kim, Un-Geo(金彦据) and Kim, In-Hu(金麟厚) as the central figure. Especially Kim, In-Hu was playing an important role in Soswaewon Garden poetry. He was wrote many of poetry and keep friends with Yang, Ja-Jeong(梁子渟) too. In the Yang, Ja-Jung, relationship of previous generation was sustained. In addition, Ko, Gyeong-Myeong(高敬命) and Kim, Seong-Won and Jeong, Chul(鄭澈) is more closely related than others. Because blood relationship by marriage. In the Yang, Jin-Tae(梁晋泰), He formed a relationship with a celebrity and attend to international activity. Since then Yang, Jin-Tae periord, Yang, Gyeong-Ji(梁敬之) and Yang, Chae-Ji(梁采之) formed relationship of previous generation was sustained. And surrounding people was written poetry as hold a banquet. Second, plant and ornament is a popular object for writing poetry. Bamboo grove and Fine tree with a high frequency of plant element in poetry. Bamboo grove is a typical species of trees in Soswaewon Garden. It was enclosed the Soswaewon Garden. Fine tree was often used target of poetry as a single tree. Meanwhile, ornament of the wall has been used most frequently. Descendants wrote a poem to see it because Kim, In-Hu's poetry was left. This phenomenon is involves respect for the ancient sages with high frequency. In addition, behavior of viewing the landscape was mainly appeared. Third, spatial recognition of Soswaewon Garden can be divided into landscape cognition, behavior cognition and emotional cognition. In a aspect of landscape cognition, early Soswaewon Garden was recognized as a pavilion. That was used garden name to 'Soswaewon Garden' since Yang, Ja-Jung's period. That is to say, Soswaewon Garden expanded from pavilion area surrounded by trees into the whole appearance is equipped garden area. Behavior cognition was consisting drink and enjoys a landscape. In the Yang, San-Bo, authors enjoyed drinking and viewing a landscape besides walking, writing poetry, viewing the moon. But after Yang, San-Bo's period other than drinking and enjoy a landscape has appeared a low frequency. These results were changed from internal place to blood relationship into external place to companionship. In the Yang, San-Bo's emotional cognition was sorrow and yearning about leave to Soswaewon Garden with an idly atmosphere. Pleasant emotion was sustained all generation. And emotion of respect for the ancient sages was appeared since Yang, Cheon-un.

Variation in Cartenoid Pigment and lipids of the Arkshell, (Anadara broughtonii) according to the Environmental Factors of the Growing Area (서식환경요인에 따른 피조개육의 Carotenoid색소와 지질성분의 변화)

  • Ha, Bong-Senk;Kang, Dong-Soo;Kim, Yung-Gwan;Kim, Kui-Shik
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.18 no.1
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    • pp.71-92
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    • 1989
  • The seasonal variations of environmental sea water, arid carotenoid and lipid composition of reddish muscle tissue of arkshell, Anadara broughtonii in Chungmu and $Y{\check{o}}su-area$ were investigated. In the sea water, pH value, salinity, electrical conductivity of Chungmu and $Y{\check{o}}su-area$ were similar tendency, but water temperature in annual average at Chungmu-area was about $2^{\circ}C$ higher than that of $Y{\check{o}}su-area$. The concentration of nitrite-nitrogen, ammonia-nitrogen, phosphate-phosphours at Chungmu-area were slightly higher than those at $Y{\check{o}}su-area$. Meanwhile the concentration of silicate-silicious at $Y{\check{o}}su-area$ was about 2 times higher than that of Chungmu-area. The bacterial density of the sea water was ranged from 3.6 to 93/100ml for coliform and 3.0 to 15/100ml for fecal colifrom at Chungmu-area, but the coliform was ranged 7.3 to 150/100ml and the fecal coliform was ranged 3.6 to 20/100ml at $Y{\check{o}}su-area$. Among the coliform, 8.9% Escherichia coli, 33.9% Citrobacter freundii, 41.1% Enterobacter aerogenes groups were classified and 16.1% was not identified. In the hemoglobin content of reddish muscle tissue of arkshell, one from Chungmu-area was ranged from 1.1 to 2.5 g /dl and one from $Y{\check{o}}su-area$ was ranged from 1.7 to 4.4 g /dl. In total carotenoid content, 0.80 to 1.28mg/100 g muscle was in Chungmu-area and 0.45 to 0.99mg/100 g muscle was in $Y{\check{o}}su-area$. Among the carotenoid compositions, pectenolone content was 63.0% in annual average from Chungmu area and 59.6% from $Y{\check{o}}su-area$, 6.5% from Chungmu area and 18.9% from $Y{\check{o}}su-area$ in ${\beta}-carotene$, 9.9% from Chungmu-area and 9.1% from Yosu-area in pectenoxanthin, 11.2% from Chungmu-area and 5.2% from $Y{\check{o}}su-area$ in diatoxanthin monoester were observed. In the seasonal variation for the major carotenoids, the content of pectenolone was continuously incresedbefore spawning period and showed the maximum in July, but decresed after spawning period. Diatoxanthin monoester was gradually incresed during all growing period from March to next January. And ${\beta}-carotene$ was decresed before spawning period and showed the maximum in July but incresed after spawning period. The major fatty acids of total lipid and fractionated lipid classes from total lipid namely neutral-, glyco- and phospholipid were $C_{16:0},\;C_{18:1},\;C_{22:6},\;C_{20:2},\;C_{18:2},\;C_{20:5}\;and\;C_{18:3}$ acid in the muscle tissue of arkshell. The content of neutral lipid showed about 2 times higher than polar lipid in the muscle tissue of arkshell from both Chungmu and, $Y{\check{o}}su-area$. The content of total and neutral lipid was decresed during spawning period. In the seasonal variation for fatty acid compositions, the content of polyenenoic acid in total and neutral lipid was decresed and saturated acid was incresed. On contrary, polyenoic acid in glyco and phospholipid was incresed and saturated acid was decresed during spawning period from July to September. The sterol composition in total lipid were mainly consisted of cholesterol, campesterol, brassicasterol and ${\beta}-sitosterol$. Especially, the rate of content in cholesterol showed decrese during spawning period butcampesterol showed increse from March to November.

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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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Efficacy and Safety of Early Bronchoscopy in Patients with Hemoptysis (객혈환자에서 조기기관지경의 유용성 몇 안정성)

  • Kim, Ho-Cheol;Cheon, Eun-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.391-400
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    • 1997
  • Background : Bronchoscopy is an essential procedure for identifying the bleeding site and evaluating cause of hemoptysis. However, it is controversial regarding to the timing of bronchoscopy in patients with hemoptysis. Early bronchoscopy, which was performed during hemoptysis or with 48hour after cessation of bleeding, was better for identifying the site of bleeding compared with delayed bronchoscopy, which was performed 48 hours after cessation of bleeding. The diagnostic yield of identifying the bleeding site by bronchoscopy was variable in reported literature and the safety of early bronchoscopy was not mentioned in previous literature. Therefore, we evaluated the efficacy and safety of early bronchoscopy in patients with hemoptysis. Method : From October 1994 to August 1996 in Samsung Medical Center, bronchoscopy was performed in patients with hemoptysis. Early bronchoscopy was performed prospectively during hemoptysis or within 48 hours after cessation of bleeding from May 1995 to August 1996. Delayed bronchoscopy group included patients who did not received early bronchoscopy at the same period or in whom bronchoscopy was performed 48 hour after cessation of bleeding from October 1994 to May 1995. Results : Early bronchoscopy group was performed 73 times in 71 patients. Delayed bronchoscopy was performed in 57 times in 55 patients. There was no difference as to amount and underlying cause of hemoptysis between both groups. Indentification of bleeding site by visualizing active bleeding was significantly higher in early bronchoscopy (38.3%) than delayed bronchoscopy group (8.7%)(p < 0.05). Indentification of bleeding site by bleeding after clot removal was 8 in early and 10 in delayed bronchoscopy. Indentification of bleeding site by visualizing active bleeding and bleeding after clot removal was 36 in early and 15 patients in delayed bronchoscopy(p > 0.05). Causes of hemoptysis was found in 18 patients in early and 16 patients in delayed bronchoscopy group. patients who had early bronchoscopy underwent surgery. We diagnosed the site of bleeding in 4 patients preoperatively. In 3 patients we made a treatment plan promptly right after bronchoscopy. Among early bronchoscopy group, bleeding over 100cc during bronchoscopy occurred in 2 patients. In early bronchoscopy group there was no other major complication during bronchoscopy. Conclusion : In patients with hemoptysis, early bronchoscopy which performed within 48 hours after cessation of bleeding was more effective procedure for identifying the bleeding site than delayed bronchoscopy which was performed after 48 hour cessation of bleeding.

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Differential Diagnosis By Analysis of Pleural Effusion (흉수분석에 의한 질병의 감별진단)

  • Ko, Won-Ki;Lee, Jun-Gu;Jung, Jae-Ho;Park, Mu-Suk;Jeong, Nak-Yeong;Kim, Young-Sam;Yang, Dong-Gyoo;Yoo, Nae-Choon;Ahn, Chul-Min;Kim, Sung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.559-569
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    • 2001
  • Background : Pleural effusion is one of the most common clinical manifestations associated with a variety of pulmonary diseases such as malignancy, tuberculosis, and pneumonia. However, there are no useful laboratory tests to determine the specific cause of pleural effusion. Therefore, an attempt was made to analyze the various types of pleural effusion and search for useful laboratory tests for pleural effusion in order to differentiate between the diseases, especially between a malignant pleural effusion and a non-malignant pleural effusion. Methods : 93 patients with a pleural effusion, who visited the Severance hospital from January 1998 to August 1999, were enrolled in this study. Ultrasound-guided thoracentesis was done and a confirmational diagnosis was made by a gram stain, bacterial culture, Ziehl-Neelsen stain, a mycobacterial culture, a pleural biopsy and cytology. Results : The male to female ratio was 56 : 37 and the average age was $47.1{\pm}21.8$ years. There were 16 cases with a malignant effusion, 12 cases with a para-malignant effusion, 36 cases with tuberculosis, 22 cases with a para-pneumonic effusion, and 7 cases with transudate. The LDH2 fraction was significantly higher in the para-malignant effusion group compared to the para-pneumonic effusion group [$30.6{\pm}6.4%$ and $20.2{\pm}7.5%$, respectively (p<0.05)] and both the LDH1 and LDH2 fraction was significantly in the para-malignant effusion group compared to those with tuberculosis [$16.4{\pm}7.2%$ vs. $7.6{\pm}4.7%$, and $30.6{\pm}6.4%$ vs.$17.6{\pm}6.3%$, respectively (p<0.05)]. The pleural effusion/serum LDH4 fraction ratio was significantly lower in the malignant effusion group compared to those with tuberculosis [$1.5{\pm}0.8$ vs. $2.1{\pm}0.6$, respectively (p<0.05)]. The LDH4 fraction and the pleural effusion/serum LDH4 fraction ratio was significantly lower in the para-malignant effusion group compared to those with tuberculosis [$17.0{\pm}5.8%$ vs. $23.5{\pm}4.6%$ and $1.3{\pm}0.4$ vs. $2.1{\pm}0.6$, respectively (p<0.05)]. Conclusion : These results suggest that the LDH isoenzyme was the only useful biochemical test for a differential diagnosis of the various diseases. In particular, the most useful test was the pleural effusion/serum LDH4 fraction ratio to distinguish between a para-malignant effusion and a tuberculous effusion.

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Pulmonary Mycoses in Immunocompromised Hosts (면역기능저하 환자에서 폐진균증에 대한 임상적 고찰)

  • Suh, Gee-Young;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Kim, Tae-Sung;Chung, Man-Pyo;Kim, Ho-Joong;Han, Jong-Ho;Choi, Dong-Chull;Song, Jae-Hoon;Kwon, O-Jung;Rhee, Chong-H.
    • 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.

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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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