• Tuberculosis and Respiratory Diseases
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• 제57권2호
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• pp.197-200
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• 2004

흉부방선균증은 임상양상 및 방사선학적 소견이 폐의 기타 염증성 질환이나 악성암과 유사한 경우가 많아 감별진단에서 놓치기 쉬우나, 대부분 항생제 치료에 좋은 반응을 보이므로 조기진단을 위한 적극적 접근으로 심각한 합병증의 발생 및 불필요한 수술을 막아야 한다. 저자들은 폐암을 의심하여 시행한 검사도중 폐를 침범하는 방선균증을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 중환자간호학회지
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• 제3권2호
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• pp.61-76
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• 2010

Purpose: This study was aimed to construct an algorithm of dyspnea emergency care and develop a simulation scenario for emergency care of dyspnea based on the algorithm. Methods: The first stage of this methodological study was to construct a preliminary algorithm based on a literature review, and content and clinical validity were established. Reflecting the result of content and clinical validity for this preliminary algorithm, simulation scenario was developed based on the modified Bay Area Simulation Collaborative scenario template. The content validity of this scenario was established, and clinical applicability was tested by applying this scenario to nurses. Results: The final simulation scenario of emergency care of dyspnea consisted of scenario overview, curricular integrity, and scenario script. The scenario was proceeded on 7 phases of the algorithm as follows; initial assessment, immediate emergency care, reassessment of dyspnea, monitoring respiratory failure, checking pulse if respiratory failure occurs, decision making on cardiopulmonary resuscitation or intubation, determining a differential diagnosis according to origin of dyspnea. Conclusion: The simulation scenario of emergency care of dyspnea developed in this study may provide a strategy of simulation education for emergency care of dyspnea for nurses.

• Journal of Yeungnam Medical Science
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• 제21권2호
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• pp.133-142
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• 2004

Chronic obstructive pulmonary disease(COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

• Tuberculosis and Respiratory Diseases
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• 제44권2호
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• pp.223-231
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• 1997

A total of 322 patients with endobronchial tuberculosis (8.1%) out of 3,982 subjects who had a flexible fiberoptic bronchoscopic examination at the Department of Pulmonary Medicine of Hanyang University Hospital between the beginning of March 1982 and the end of April 1996 were included in this study. The peak incidence occurred in the second decade, and the male to female was 1 : 3.0. The barking cough with variable amounts of sputum was the most common chief complaint in 56.9% of the 313 patients. Other complaints included dyspnea, chest pain, fever, hemoptysis, and generalized weakness. Localized wheeze was heard over the chest in 16.9% of the 313 patients. Infiltration/consolidation was the most common roentgenographic finding of the chest in 64.2%. Bronchoscopically, hypertrophy with luminal narrowing was the most common findings in 32.3% of the 322 patients and left main bronchus was the most frequently involved in 24.0%. Using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also makes a differential diagnosis of lung cancer in older patients. We need further evaluations of standard bronchoscopic classification of endobronchial tuberculosis, diagnostic accuracy of endobronchial tuberculosis by PCR, a large prospective study of effects of corticosteroids in endobronchial tuberculosis patients, and appropriate treatment of atelectasis by endobronchial tuberculosis.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.1-5
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• 2019

Quitting smoking helps smokers maintain their health and extend their lifespan by 10 or more years. Treatment strategies for smoking cessation should be tailored to individual smokers with special needs based on their specific circumstances. It is recommended that pregnant women adopt smoking cessation through counseling and behavioral interventions because the safety of medications has yet to be established. Counseling is the main strategy for smoking cessation in adolescents and nicotine replacement therapy can be used with caution in individuals with serious nicotine dependence. It is important for smokers with psychiatric diseases to quit smoking following accurate assessment of their depression status. Nicotine replacement therapy, varenicline, and bupropion can be used for smoking cessation in smokers with psychiatric disorders. The incidence of cardiovascular disease decreased according to the smoking status and the duration of smoking cessation. In smokers with chronic obstructive pulmonary disease (COPD) who used a combination of counseling and pharmacotherapy the quitting rate was more than twice as high as subjects who used behavioral interventions alone. Varenicline can be used as the most effective anti-smoking drug by most smokers including those with psychiatric disorders, cardiovascular disease, and COPD.

• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.40-51
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• 2024

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia with a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomes but remains a major medical challenge due to variability in clinical presentation and the shortcomings of existing diagnostic tests. Medical history collection is the first and most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarette smoking. Systemic assessment for connective tissue disease is essential in the initial evaluation of patients with suspected IPF to identify potential causes of interstitial lung disease (ILD). Radiologic examination using high-resolution computed tomography plays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computed tomography images can be considered. If additional tests such as surgical lung biopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsy should be considered as an alternative to surgical lung biopsy in medical centers with experience performing this procedure. Diagnosis through multidisciplinary discussion (MDD) is strongly recommended as MDD has become the cornerstone for diagnosis of IPF, and the scope of MDD has expanded to monitoring of disease progression and suggestion of appropriate treatment options.

• 한국산업보건학회지
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• 제20권4호
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• pp.274-281
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• 2010

The objectives of this study are (a) to investigate the distribution patterns and exposure concentrations of biological agents in sawmill industries and (b) to compare sampling methods of biological agents. The representative processes of 5 sawmills were selected to measure total airborne bacteria, fungi, endotoxin as well as dust. Airborne bacteria and fungi were measured with one stage impactor, six stage impactor and gelatin filteration methods. Endotoxin was collected with polycarbonate filters and analysed by kinetic chromogenic Limulus Amebocyte Lysate method. Geometric mean levels of airborne bacteria, fungi, endotoxin and dust were 1,864 CFU/$m^3$, 2,252 CFU/$m^3$, 31.5 EU/$m^3$ and 2.4 mg/$m^3$. The ratios of indoor/outdoor concentrations were 3.7 for bacteria, 4.1 for fungi, 3.3 for endotoxin and 9.7 for dust. The respiratory fractions of bacteria were 68.0, 50.9, 49.2 and 45.1% in band-saw, table-saw, rip-saw process and outdoor air. The respiratory fractions of fungi were 78.7, 90.8, 87.5 and 84.8% in band-saw, table-saw, rip-saw process and outdoor air, respectively. There was no significant differences in bacterial concentrations among single stage, six stage impaction and filteration methods. But, fungal concentrations measured with filtration methods were significantly higher than those with impaction methods. Geometric mean levels of airborne bacteria and fungi were higher than the OSHA guideline values of 1,000 CFU/$m^3$. The respiratory fractions of fungi were above 75%. The concentrations of biological agents were significantly different among culture-based sampling methods. In the exposure assessments of biological agents, further studies are needed for the comparisons of diverse sampling methods and the investigations of environmental factors.

• Tuberculosis and Respiratory Diseases
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• 제80권1호
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• pp.52-59
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• 2017

Background: Inhaled indacaterol (Onbrez Breezhaler), a long-acting ${\beta}_2$-agonist, is approved in over 100 countries, including South Korea, as a once-daily bronchodilator for maintenance and treatment of chronic obstructive pulmonary disease (COPD). Here, we present an interim analysis of a post-marketing surveillance study conducted to evaluate the real-world safety and effectiveness of indacaterol in the Korean population. Methods: This was an open-label, observational, prospective study in which COPD patients, who were newly prescribed with indacaterol (150 or $300{\mu}g$), were evaluated for 12 or 24 weeks. Safety was assessed based on the incidence rates of adverse events (AEs) and serious adverse events (SAEs). Effectiveness was evaluated based on physician's assessment by considering changes in symptoms and lung function, if the values of forced expiratory volume in 1 second were available. Results: Safety data were analyzed in 1,016 patients of the 1,043 enrolled COPD patients receiving indacaterol, and 784 patients were included for the effectiveness analysis. AEs were reported in 228 (22.44%) patients, while 98 (9.65%) patients reported SAEs. The COPD condition improved in 348 patients (44.4%), while the condition was maintained in 396 patients (50.5%), and only 40 patients (5.1%) exhibited worsening of ailment as compared with baseline. During the treatment period, 90 patients were hospitalized while nine patients died. All deaths were assessed to be not related to the study drug by the investigator. Conclusion: In real-life clinical practice in South Korea, indacaterol was well tolerated in COPD patients, and can be regarded as an effective option for their maintenance treatment.

• 보건행정학회지
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• 제25권4호
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• pp.256-263
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• 2015

Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

• 대한수의학회지
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• 제58권1호
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• pp.9-16
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• 2018

A preliminary study into the protective mechanisms of adaptive immunity against porcine reproductive and respiratory syndrome virus (PRRSV) in piglets (n = 9) born to a gilt challenged intranasally with a type-2 PRRSV. Immune parameters (neutralizing antibodies, $CD3^+CD4^+$, $CD3^+CD8^+$, $CD3^+CD4^+CD8^+$ T-lymphocytes, and PRRSV-specific interferon $(IFN)-{\gamma}$ secreting T-lymphocytes) were compared with infection parameters (macro- and microscopic lung lesion, and PRRSV-infected porcine alveolar macrophages ($CD172{\alpha}^+PRRSV-N^+\;PAM$) as well as with plasma and lymphoid tissue viral loads. Percentages of three T-lymphocyte phenotypes in 14-days post-birth (dpb) peripheral blood mononuclear cell (PBMC) had significant negative correlations with percentages of $CD172{\alpha}^+PRRSV-N^+\;PAM$ (p < 0.05) as well as with macroscopic lung lesion (p < 0.01). Plasma and tissue viral loads had significant (p < 0.05) negative correlations with $CD3^+CD4^+CD8^+$ T-lymphocyte percentage in PBMC. Frequencies of $CD3^+CD8^+$ and $CD3^+CD4^+$ T-lymphocytes in 14-dpb PBMC had significant negative correlations with of lymph node (p = 0.04) and lung (p = 0.002) viral loads. $IFN-{\gamma}$-secreting T-lymphocytes frequency had a significant negative correlation with gross lung lesion severity (p = 0.002). However, neutralizing antibody titers had no significant negative correlation (p > 0.1) with infection parameters. The results indicate that T-lymphocytes contribute to controlling PRRSV replication in young piglets born after in-utero infection.