• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.459-464
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• 2005

연구 배경 : Adenosine deaminase (ADA)는 퓨린 (purine) 대사에 작용하는 효소로서 림 프구, 특히 T-림프구의 증식과 분화에 관여하며, 결핵성 흉수의 진단에 있어서 중요한 생화학적 표지자 중의 하나이다. 한편, 노인의 경우, T-림프구의 수와 기능의 감소에 의하여 면역 기능이 감소하는 것으로 알려져 있다. 이에 저자 등은 노인 결핵성 흉수 환자에서 흉수내의 ADA 수치가 젊은 환자에서보다 감소하는지를 조사하였다. 방 법 : 4년 동안 세브란스 병원에서 1) 흉수 결핵균 배양 양성 또는 2) 흉막 조직 검사상 결핵에 합당한 소견을 보여 결핵성 흉수로 진단받은 환자 80명을 대상으로 후향적으로 조사하였다. 65세를 기준으로 두 군으로 분류하였으며, 연령과 흉수 ADA 수치의 연관 관계를 독립 표본 t-검정 및 선형 회귀 분석을 이용하여 연구하였다. 결 과 : 80명의 환자 중 65세 이상은 21명 (26.3%)이었다. 흉수 내의 ADA 수치는 65세 이상 및 이하 군에서 각각 $71.2{\pm}27.6IU/L$, $68.5{\pm}5.8IU/L$ 이었다 (p=0.69). 선형 회귀 분석에서도 연령과 흉수 내의 ADA 수치는 상관 관계를 보이지 않았다 ($r^2=0.05$, p=0.59). 결 론 : 본 연구의 결과에 의하면, 결핵성 흉수의 진단에서 흉수 ADA 수치를 보조 지표로 사용하는 데 있어서, 노인환자에서도 젊은 환자와 동일한 임상적 유의성을 가지고 동일한 결정 수치 (cut-off value)를 적용할 수 있을 것으로 판단된다.

• Tuberculosis and Respiratory Diseases
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• v.66 no.5
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• pp.390-395
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• 2009

Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.324-328
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• 2009

The syndrome of inappropriate secretion of the antidiuretic hormone (SIADH) is a well recognized paraneoplastic phenomenon related to impaired water excretion, and can result in dilutional hyponatremia as well as central nervous system symptoms. It is characterized by a decrease in plasma osmolarity with inappropriately concentrated urine. The causes of SIADH are associated with pulmonary and endocrine disorders, central nervous system diseases, and malignancies, including lung cancer. The other causes of SIADH include some drugs, particularly chemotherapy agents. Anticancer drugs, such as cisplatin, vincristine, and cyclophosphamide are well known causes of SIADH but the mechanisms are unclear. Recently, we encountered a patient with advanced non-small cell lung cancer who suffered from general weakness and altered mentality after an intravenous carboplatin and gemcitabine combination.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.549-553
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• 2007

Sarcoidosis is a multi-systemic syndrome of an unknown etiology, and it is characterized by the formation of multiple noncaseating granulomas that disrupt the architecture and function of the tissues in which they reside. The most commonly affected organs are lung, skin and lymph nodes. Overt clinical involvement of the nervous system is uncommon and this occurs in about 5% of all patients during the course of their disease. The most common manifestations are granulomatous leptomeningitis, cranial nerve palsy, electrolyte or other endocrinologic abnormalities, but isolated memory impairment is a rare manifestation. This is a case of 59 years-old male with recent memory impairment, and he was previously diagnosed with pulmonary sarcoidosis by transbronchial lung biopsy. The brain MRI imaging revealed the leptomeningeal and parenchymal involvement of sarcoidosis. He was treated with high dose corticosteroid and his memory function was improved to nearly a normal level. We report here on a case of successful treatment of pulmonary sarcoidosis combined with neurosarcoidosis with using high dose corticosteroid, and the patient presented with recent memory impairment.

• Journal of Korean Society for Atmospheric Environment
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• v.27 no.6
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• pp.711-722
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• 2011

This study is aimed to estimate the $PM_{2.5}$ source apportionment at Seoul intensive monitoring site located in Seoul metropolitan area. Time-resolved chemical compositions of $PM_{2.5}$ are measured in real time using ambient ion monitor, semi-continuous carbon monitor, and on-line XRF at Seoul intensive monitoring site in 2010. The mass concentration of $PM_{2.5}$ was simultaneously monitored with eight ionic species (${SO_4}^{2-}$, $NO_3{^-}$, $Cl^-$, $NH_4{^+}$, $Na^+$, $K^+$, $Mg^{2+}$, $Ca^{2+}$), two carbonaceous species (OC and EC), and fourteen elements (Si, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Zn, As, Se, Pb) in 1-hr interval. The data sets were then analyzed using EPA PMF version 3 to identify sources and contributions to $PM_{2.5}$ mass. EPA PMF modeling identified eight PM2.5 sources, including soil dust, secondary sulfate, secondary nitrate, motor vehicle, coal combustion, oil combustion, biomass burning, and municipal incineration. This study found that the average $PM_{2.5}$ mass was apportioned to anthropogenic sources such as motor vehicle, fuel combustion, and biomass burning (61%) and secondary aerosols, including sulfate and nitrate (38%).

• Journal of Chest Surgery
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• v.36 no.8
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• pp.630-632
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• 2003

In off-pump coronary artery bypass grafting (CABG), multiple proximal anastomosis may increase the risk of cerebral embolism (air, debris) and aortic injury (dissection, pseudoaneurysm). Radial artery (RA) has no intraluminal valve such as saphenous vein. We applied Cabrol technique using aortic root replacement for proximal anastomosis in off-pump CABG. Cabrol technique using RA graft can reduce numbers of proximal anastomosis and reduce number of aortic manipulation in off-pump CABG. We report a Cabrol technique for proximal anastomosis in off-pump CABG with RA graft.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.551-555
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• 2005

Hemangiopericytoma is a rare neoplasm that originates from small peri-capillary spindle shaped cells called pericytes. The most common sites of origin are the thigh, the pelvis and the retroperitoneum. A primary pulmonary hemangiopericytoma is particularly unusual. However, more than 50% of hemangiopericytoma cases metastasize to the lungs, the bone, and the liver. A long-term clinical and radiological follow up is recommended due to the high risk of recurrence of a potential malignancy. We report a case of a metastatic hemangiopericytoma in the lung that had initially developed in the thigh of a 53 year-old woman 6 years ago. The authors emphasize the long-term follow-up of this type of rare sarcoma.

• Publications of The Korean Astronomical Society
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• v.28 no.2
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• pp.25-36
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• 2013

Chumsungdae is an ancient astronomical observatory whose main role was doing 'chunmoon'. It was administrate by a royal advisory agency on state affairs. The observers observed the heaven on the observatory platform, recorded peculiar events, and watched and interpreted the signs displayed in the heaven. Chumsungdae is an stonemasonry which represents almanac principles with its peculiar shapes and the numbers of strata and stones. The numbers were thoroughly invented to match exactly the almanac constants. Chumsungdae is comprised largely of three main parts, namely the square base, the stratified cylindrical body, and the top #-shaped stonework, and the total number of stones is 404. The number of the strata (27) and the height of the cylindrical body (27 尺) stand for the days in a sidereal month (27.3 days), which implies that the motion of the Moon with respect to the stars was given more priority than to the Sun at that time of geocentricism. And the cylindrical body was thoroughly designed to consist of 365 stones, which is of course the number of days in a solar year. In addition, there are 12 strata each under and above the south entrance and this in sum makes the 24 divisions of the year. Also there is 182 stones below the 13th stratum and this represents the number of days in the winter ~ summer solstice period, and the rest 183 stones the vice versa. The #-shaped top stonework was aligned in such a way that one of the diagonals points the direction of sunrise on the winter solstice. The square base also layed with the same manner. The south entrance was built 16 degrees SE, and the upright direction of the right pillar stone coincides with the meridian circle. This was a kind of built-in standard meridian circle facilitating the observations. In a symbolic sense, Chumsungdae was thought as the tunnel reaching the heaven, where the observers wished to be enlightened with the signs and inspirations in need. With the craftsmanship and skill, the builder reinforced the stratified cylindrical body with two sets of #-shaped beam stones, piercing at a right angle at 19th ~ 20th and 25th ~ 26th strata. Likewise, by placing the double #-shaped stonework with 8 beam stones on the platform of the observatory, both the stability of the stonemasonry and a guard rail for the nightly observers were securely provided.

• PNF and Movement
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• v.16 no.1
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• pp.43-50
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• 2018

Purpose: This study examined the effects of a shoulder-strengthening exercise on muscle strength of shoulder flexors and extensors of caregivers. Methods: The study consisted of 19 caregivers (2 males and 17 females) employed by Medical Center B. All the participants took part in an 8-week shoulder muscle strengthening exercise, based on previous studies. In the first week, the subjects took part in a stretching exercise enhance the range of motion. In the second week, they participated in an exercise aimed at improving shoulder blade stability. From the third to seventh weeks, a resistance exercise of different intensities was applied in a phased manner. Finally, in the eight week, the subjects took part in plyometric exercise. Peak torque, average power, and total work of shoulder flexors and extensors in both sides were measured before and after the exercise at an angular speed of 120deg/sec using an isokinetic device. Wilcoxon's singed-ranks test was conducted to analyze differences in muscle strength before and after the intervention. Results: After the exercise, there was a significant improvement in peak torque and average power of flexors of the right arm. After the exercise, peak torque, total work, and average power showed a significant improvement in the flexors of the left arm (p<0.05). However, there was no statistically significant difference in extensor muscle strength in either arm after the exercise. Conclusion: Shoulder flexors of caregivers are utilized frequently in the workplace. Implementation of extensor-strengthening exercises, in addition to flexor-strengthening exercises, can contribute to reducing the incidence rate of shoulder injuries among caregivers.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.124-129
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• 2009

Background: The "gold standard" for proper epidural catheter positioning is a clinical response, as assessed by a pinprick test. Yet it may take time or it may be difficult to perform this test after epidural catheter placement in sedated or uncooperative patients or during general anesthesia. We assessed the usefulness of aspirating injected air via an epidural catheter as an indicator of correct epidural catheter placement. Methods: We surveyed 200 patients who underwent surgery under general or epidural anesthesia. A Tuohy needle was inserted into the epidural space with using the hanging drop technique. After placement of the epidural catheter, 3 ml of air was injected via the catheter, and then the volume of aspirated air was measured. Results: The mean volume of aspirated air was $2.3{\pm}0.7ml$ (75% of the injected air volume) and this ranged from 0 to 3 ml. Conclusions: Aspiration of injected air is a simple alternative method for identifying the appropriate placement of epidural catheters in the epidural space.