• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.101-104
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• 2015

A 55-year-old man was admitted to the hospital for jaundice. Computed tomography (CT) scans showed a diffuse mass in the pancreas and peripancreatic area, with infiltration to of the whole pancreas, and overall reduced enhancement compared to normal pancreas. Esophagogastroduodenoscopy revealed elevated mucosal lesion covered hyperemic mucosa at duodenal bulb and ulcerative lesion at body of stomach. Endoscopic ultrasonography revealed an irregular mass with unclear boundaries was observed within the pancreas. Abrupt narrowing of mid to distal common bile duct was seen and the stricture was caused by compression of pancreatic mass. Plastic stent was inserted and clinical improvement was achieved including resolution of jaundice. The patient is currently being treated with combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone. We report a case of primary pancreatic lymphoma presenting with obstructive jaundice.

• Tuberculosis and Respiratory Diseases
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• v.86 no.4
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• pp.272-283
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• 2023

Background: In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. Methods: We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. Results: Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=-0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). Conclusion: Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established.

• Journal of Nutrition and Health
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• v.41 no.4
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• pp.307-316
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• 2008

The purpose of the study was to investigate nutritional status of chronic obstructive pulmonary disease (COPD) patients and to find out the differences according to the stages of disease. From March to October, 2006, 41 stable male patients of mild to severe COPD patients were recruited from Seoul National University hospital. The patients' of body weight and fat free mass were assessed by bioelectrical impedance analysis. The nutritional status of the patients was also assessed by 3-day recall, index of nutritional quality (INQ), dietary diversity score (DDS), dietary variety score (DVS), food group index pattern and dietary quality index (DQI). The total of 41 patients were classified into three groups, stage I, stage II and stage III groups according to the classification of Global Initiative for Chronic Obstructive Lung Disease (GOLD) standard. The mean age of the patients in each stage were 67.2-66.9 years showing no significant difference. The ratio of $FEV_1$/FVC were $57.5{\pm}7.3$, $46.9{\pm}7.6$ and $38.2{\pm}6.8%$, respectively showing significant differences according to the stages of disease. The fat free mass of the stage II ($48.2{\pm}4.7kg$) and III ($47.3{\pm}4.5kg$) was significantly lower than that of stage I ($53.1{\pm}6.9kg$) patients. There were significant correlation of fat free mass with $FEV_{1}$, and BMI (body mass index) with $FEV_{1}$/FVC ratio (p < 0.05). COPD patients showed the diet-related clinical symptoms of anorexia, dyspnea, dyspepsia, and chewing difficulty. Daily intakes of calorie, K, vitamin $B_2$ and folate of the patients were very low ($83.8{\pm}20.7%$, $58.9{\pm}14.4%$, $70.7{\pm}19.6%$ and $74.4{\pm}10.2%$, respectively) however, they did not significantly different according to the stages of disease. Daily intake of calcium was significantly lower in the stage III patients (p < 0.05). The mean scores of dietary variety score was significantly lower in the stage III patients (p < 0.001). Dietary quality index of the patients were not different among the stages of disease and the scores indicated poor quality of diet. As a summary, we found that body fat free mass, regularity of exercise, frequency of having snacks and dietary variety score were significantly associated with the severity of chronic obstructive pulmonary disease.

• Journal of the Korean Applied Science and Technology
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• v.37 no.3
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• pp.604-612
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• 2020

The purpose of this study is to analyze the level of obesity and sarcopenia among chronic obstructive pulmonary disease(COPD) patients in Korea. The current study recruited 75 patients with COPD who visited the department of respiratory medicine at J University Hospital in J-do. Height, body weight, waist circumference, and hip circumference were measured, and body composition, muscle strength, and flexibility were assessed. The levels of obesity were classified with body mass index(BMI), waist-hip circumference ratio(WHR) and percent body fat, and sarcopenia was classified with the value of skeletal muscle mass and muscle strength by Asian Working Group for Sarcopenia. In results, it was found that the level of obesity was very high as 43% by BMI, 88% by WHR, and 64% by percent body fat. The lower level of muscle strength was 15.50% in males and 23.50% in females. The lower level of muscle mass was 24.10% in males and .00% in females. Males who had one sarcopenia factors were 22.40%, and females were 23.50%, respectively. Males with sarcopenia were 6.90%, and females were .00%. In conclusion, regular resistance exercise is essential not only for the development of motor skills, but also for the normalization of skeletal muscle function and prevention of muscle dystrophy among COPD patients.

• Journal of Digestive Cancer Research
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• v.5 no.1
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• pp.50-54
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• 2017

Pancreatic neuroendocrine tumors are rare pancreatic neoplasms comprising 1-2% of all pancreatic tumors and typically present high attenuating mass on arterial and venous phase images, due to their rich capillary network. A 70-year-old South Korean female visited our hospital presenting with jaundice and dark urine color. She had received an operation for treatment of small bowel perforation seven years ago. On physical examination, icteric sclera was observed but otherwise unremarkable. Laboratory tests were abnormal liver function test and suspected obstructive jaundice. Computed tomography revealed 4 cm sized cystic mass lesion with homogeneous low attenuation in the head of pancreas and distal common bile duct was compressed by the mass. During review of past medical records, we found that the mass was observed and measured about 1.7 cm seven years ago. To resolve obstructive jaundice, pylorus preserving pancreaticoduodenectomy was performed and diagnosed with well differentiated pancreatic neuroendocrine carcinoma with intermediate grade.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.3
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• pp.212-217
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• 2006

Obstructive sleep apena syndrome (OSAS) is accompanied by the following symptoms: apnea caused by upper respiratory tract obstruction while sleeping, repetitive lowering of $SpO_2$, severely affected excessive daytime sleepiness (EDS), suffocation/frequent awakeness while sleeping, daytime lethargy, and lack of concentration. OSAS was investigated with sex, age, body weight, body mass index (BMI), neck circumference and snoring sound as clinical characteristics and the anticipating factors of OSAS were studied in relation with the apnea-hypopnea index (AHI). The subjects were 42 people (male 34/female 8) who visited the clinic due to snoring and had polysomnography evaluation. AHI was differenciated into normal (less than 0~5/hr), mild (5~15/hr), moderate (15~30/hr) and severe (more than 30/hr). As the apnea-hypopnea index (AHI) gets higher, the snoring sound was louder (p<0.01), neck circumference was thicker (p<0.05) and also there were relative correlations with body weight (p<0.01), body mass index (p<0.05), snoring sound (p<0.01) and neck circumference (p<0.01). Since the snoring sound and neck circumference explained 32.8% of the AHI distribution, if the patient was severely snoring or had a thick neck circumference due to obesity, the apnea-hypopnea index showed a predisposition to the obstructive sleep apnea syndrome.

• Tuberculosis and Respiratory Diseases
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• v.87 no.1
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• pp.80-90
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• 2024

Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.

• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.124-129
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• 2023

A 5-year-old neutered male domestic short-haired cat presented with acute dyspnea characterized by open-mouth breathing and stridor for 2 days. Direct visualization via laryngoscopy revealed diffuse laryngeal swelling and severe thickening of the vocal folds bilaterally; thus, the upper respiratory tract was obstructed owing to severe edema. Neutrophil infiltration was found on fine needle aspiration of the larynx cytology, and no discrete mass with polyp or neoplasia was identified on diagnostic imaging. The cat was diagnosed with acute obstructive laryngitis, and a tracheostomy tube was immediately installed. After 17 days of treatment with steroids, doxycycline and azithromycin, the swollen larynx gradually improved, and there was no recurrence of laryngitis or respiratory obstruction. A feline upper respiratory polymerase chain reaction panel revealed Mycoplasma felis infection; however, it could not be determined whether it was pathogenic or opportunistic. Herein, we report a case of obstructive laryngitis in a cat. When respiratory obstruction due to acute laryngitis is identified, a good prognosis is expected with rapid and appropriate treatment.

• Annals of Clinical Neurophysiology
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• v.17 no.2
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• pp.61-67
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• 2015

Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.366-369
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• 1992

A chest x-ray of 68 year old male showed pneumonic consolidation of right lower lung field with blunting of right cardiac border. Computerized tomography of chest revealed infiltrative mass with V-shaped calcification just below right main bronchus. This finding has to be made into differential diagnosis of numerous pulmonary diseases including, mycobacterial disease, neoplasm, lymphadenopathies, and foreign bodies. Initial bronchoscopic findings suggest endobronchial mass lesion on right intermediate bronchus but endobronchial biopsy fail to prove malignant cell or underlying illness. But repeated endobronchial biopsy shows metallic material in the right Intermediate bronchus and we remove it with alligator jaws forcep under bronchoscopy. He was well after discharge.