• Journal of Chest Surgery
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• 제33권5호
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• pp.377-384
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• 2000

Background: Numerous studies of safe, long term preservation for lung transplantation have been performed using ex vivo models or in vivo single lung transplantation models. However, a safe preservation time which is applicable for clinical use is difficult to determine. We prepared LPDG solution for lung preservation study. In this study we examined the efficacy of LPDG(low potassium dextran glucose) solution in 24-hour lung preservation by using a sequential bilateral canine lung allotransplant model. Material and Method: Seven bilateral lung transplant procedures were performed using weight-matched pairs(24 to 25kg) of adult mongrel dogs. The donor lungs were flushed with LPDG solution and maintained hyperinflated with 100% oxygen at 1$0^{\circ}C$ for a planned ischemic time of 24 hours for the lung implanted first. After sequential bilateral lung transplantation, dogs were maintained on ventilators for 3 hours: arterial resistance were determined if the recipients hourly after bilateral reperfusion and compared with pretransplant-recipient values, which were used as controls. After 2hours of reperfusion, the chest X-ray, computed tomogram and lung perfusion scan were performed for assessmint of early graft lung function. Pathological examinations for ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery were performed. Result: Five of seven experiments successfully finished the whole assessments after bilateral reperfusion for three hours. Arterial oxygen tension in the recipients was markedly decrased in immediate reperfusion period but gradually recovered after reperfusion for three hours. The pulmonary artery and pulmonary vascular resistance showed singificant elevation(p<0.05 versus control values) but also recovered after reperfusion for three hours(p<0.05 versus immediate period value). The ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery showed reversible mild injury in 24 hours of lung perservation and reperfusion. Conclusion : This study suggests that LPDG solution provides excellent preservation in a canine model in which the dog is completely dependent on the function of the transplanted lung.

• Journal of Chest Surgery
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• 제55권4호
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• pp.277-282
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• 2022

Lung transplantation is a life-saving procedure in patients with end-stage lung disease. However, it inherently depends on the availability of donor organs. The selection of suitable lungs for transplantation, management of donors to minimize further injury and improve organ function, and safe procurement remain critical for successful transplantation. In this review, we provide an update on the current understanding of donor selection, management, and lung procurement.

• 동의생리병리학회지
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• 제16권6호
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• pp.1110-1116
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• 2002

The skin(皮膚) separates epidermis(皮) and dermis(膚) in Oriental medicine. epidermis and hair come from ectoderm as dermis comes from mesoderm in embryology. Epidermis and hair belong to the Metal(金) and dermis belongs to the Earth(土) in Oriental medicine. The lung is related to the skin and hair. The skin surface is nourished by the essence from the lung, and the. lung has the function of sending wei-qi(衛氣.: defensive Energy) to the skin surface to guarantee body resistance. The skin takes nourishment from blood(血) and express by qi(氣). The supply of nutrients to the lung and skin relies on the function of the spleen, pancreas and subcutis. Flaming of the heart fire may scorch the essence of the lung-metal, inducing dermatosis.

• Tuberculosis and Respiratory Diseases
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• 제49권1호
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• pp.30-36
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• 2000

연구배경 : 흉막박피술은 만성적인 농흉으로 인한 감염 병소의 제거와 감소된 폐기능의 향상을 도모할 목적으로 시행되어져 왔는데, 박피술 후 폐기능이 개선되지 않는 경우도 있어 어떤 군에서 박피술이 유용한 지에 대해 수술 전후의 폐기능 검사를 통해 이를 검토하였다. 방법 : 1990년부터 1996년까지 서울대 병원에서 결핵성 농흉으로 흉막 박피술을 시행받은 37명의 환자를 대상으로 수술 전후의 폐기능검사를 후향적으로 분석하였다. 결과 : 환자군의 남녀비는 29 : 8, 나이의 중앙값은 34세(15-68)였다. 농흉의 발생부터 수술까지의 기간은 1개월에서부터 30년까지 다양했으며, 수술 후 폐기능 검사는 평균 5.4$\pm$2.6 개월에 행해졌다. 1. 전체 환자에서 FVC는 수술 전 2.77$\pm$0.67(L)에서 2.95$\pm$0.81 (L)로 유의하게 증가했다(p=0.02). 2. 40세 이하의 환자 군에서 40세 이상의 환자 군보다 FVC가 유의하게 증가했다(p=0.01). 3. 진단후 4개월 이내 조기 흉막박피술을 시행받은 군에서 진단 4개월 이후 시행받은 군보다 더욱 큰 FVC의 증가를 보였다(p=0.007). 4. 수술 전 폐기능검사에서 FVC가 예상치의 60% 이하로 감소되어 있던 군이 예상치의 60% 이상이었던 군에 비해 수술 후 FVC 의 유의한 증가를 보였다 (p=0.047). 5. 수술 전 흉부 방사선학적 검사상 흉막에 석회화를 동반하지 않은 군이 석회화를 동반한 군에 비해 FVC의 증가가 유의했다(p=0.02). 결론 : 이상의 결과에서 흉막박피술은 전반적으로 환자의 폐기능의 증가를 가져왔으며, 특히 40세 이전의 젊은 환자, 농흉 발생 후 4개월 이내 흉막 박피술을 시행했을 경우, 수술 전 폐활량이 예상치의 60%이하로 감소되었던 경우와 흉막에 석회화를 동반하지 않았을 때가 도움이 되었다.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.177-183
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• 2010

Background: Smoking reduces pulmonary function and induces various lung diseases. Recently, the rate of emphysema detection has increased due to lung cancer screening with low-dose chest computed tomography (CT). The purpose of this study was to evaluate changes in lung function associated with emphysema in healthy smokers. Methods: One hundred and ninety one healthy smokers, who had undergone a low-dose chest CT (LDCT) scan as part of lung cancer screening and had revisited the health center after a median 23.9 months' time, were recruited into this study. The severity of emphysema was calculated by the direct observation of a radiologist and a pulmonologist indipendently. Longitudinal changes in lung function according to emphysema based on LDCT and type of smoker was analyzed. Results: Of the participants in this study, 25% of healthy smokers had emphysema, which was mild in severity, in older patients (p=0.003) and in heavy smokers (p<0.001). $FEV_1/FVC$ and FEF25-75% were decreased in current smokers with emphysema (p=0.001 and p=0.009, respectively) and without emphysema (p=0.001 and p=0.042). Although lung function was not decreased in ex-smokers without emphysema, $FEV_1/FVC$ and FEF25-75% were decreased in ex-smoker with emphysema (p=0.020 and p=0.010). Conclusion: Upon examination with LDCT, the prevalence of emphysema was higher in healthy smokers was than in non-smokers. Lung function was diminished in smokers with emphysema, in spite of former smoker.

• Tuberculosis and Respiratory Diseases
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• 제71권3호
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• pp.202-209
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• 2011

Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second ($FEV_1$), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and $FEV_1$, % predicted (B=-0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.624-631
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• 2017

본 연구의 목적은 머리 전방 자세 성인에 대하여 8주간 슬링에서의 푸쉬업 플러스 운동이 근활성도와 폐기능에 어떠한 영향을 미치는지 알아보고자 하였다. 총 16명의 머리 전방 자세 성인이 모집 되었고 대조군과 실험군으로 각 8명씩 배정 되었다. 슬링에서의 니푸쉬업 플러스와 안정한 면에서 니푸쉬업 플러스 운동을 2015년 7월 6일부터 8월 28일까지 8주간 나누어 시행하였고 주 3회 실시하였다. 머리 척추각을 측정시 두군에서 (p<0.001)의 증가를 보였고 머리 회전각 측정시 대조군에서 (p<0.05), 실험군에서 (p<0.001)의 감소를 보였다. 두 군에서 근활성도는 위 등세모근(p<0.001)의 감소와 앞톱니근, 아래 등세모근의(p<0.001)의 증가를 나타내었고 폐기능 측정시 대조군에서(p<0.01), 실험군에서(p<0.001)의 증가를 보였다. 결론적으로 푸쉬업 플러스 운동은 머리 전방 자세를 개선시키고 호흡근들의 활성화를 높일뿐더러 폐기능 강화에 효과적이며 슬링에서의 푸쉬업 플러스 운동이 머리 전방 자세의 개선에는 더욱 효과적이지만 폐기능에는 유의한 차이가 없었다. 따라서 슬링에서의 푸쉬업 플러스 운동은 머리 전방자세 성인의 자세 개선과 폐기능에 효과적인 운동으로 추천 된다.

• 국제물리치료학회지
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• 제9권1호
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• pp.1393-1397
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• 2018

The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to $.30{\pm}0.31{\ell}$, $.46{\pm}.42{\ell}$, and $18.10{\pm}11.39%$, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to $-2.20{\pm}1.40^{\circ}$ and $-1.20{\pm}1.14^{\circ}$, respectively (p<.01). For spinal mobility, the thoracic flexion ($3.40{\pm}2.99^{\circ}$), thoracic extension ($3.50{\pm}1.43^{\circ}$), lumbar flexion ($4.50{\pm}4.74^{\circ}$), and lumbar extension($-1.50{\pm}1.84^{\circ}$) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases.

• 한국임상약학회지
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• 제30권3호
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• pp.149-160
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• 2020

Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.

• Tuberculosis and Respiratory Diseases
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• 제87권2호
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.