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A Clinical Study of Pulmonary Hamartoma -Analysis of 41 Reported Cases in Korea Including 13 Cases in Severance Hospitol- (폐과오종에 대한 임상적 고찰 -국내 문헌 보고 41예를 포함한 세브란스 병원 13예에 대한 분석-)

  • Kim, Sung-Eun;Lee, Hong-Lyeol;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young;Choe, Kyu-Ok;Chung, Kyung-Young;Shin, Dong-Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.565-574
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    • 1993
  • Background: Pulmonary hamartomas are benign tumors that occur in the parenchyma or in the bronchi. They present as a solitary pulmonary nodule(SPN) or as a cause of bronchial obstruction. The incidence, once minimal, is increasing in Korea. To get clinical spectrum about the tumor, we analyzed all the reported cases in Korea since 1964. Methods: We reviewed the clinical, radiological and pathological findings of 13 patients of intrapulmonary or endobronchial hamartomas in Severance Hospital and of 38 reported cases in Korea published in literatures from 1964 to 1992 retrospectively. Results: Including 17 endobronchial hamartomas, 54 cases were studied. There were 25 men and 29 women, with a mean age of 47.2 years; 45.3 years in endobronchial type and 51.3 years in parenchymal type. Pulmonary symptoms were present in 8 patients (22%) of intrapulmonary type and in all patients of endobronchial type: cough (65%), dyspnea (53%), sputum (35%), fever (29%) in order. On chest X-rays, atelectasis was seen in 10 patients (59%) in endobronchial type; but SPN was noted in 36 patients (97%) of intrapulmonary type. Calcification was present in 7 intapulmonary hamartomas (23%); but is in 2 endobronchial hamartomas (12%). The diagnostic yield was 6 out of 14(43%) in endobronchial ones; 4 out of 7(57%) in intrapulmonary ones. Fifty patients underwent operations as follows: lobectomy (28), enucleation (8), resection (8), bilobectomy (4), pneumonectomy (2). The hamartomas were 1.2 times more common in the right lung; mean transverse diameter at the time of operation was 2.3 cm in endobronchial type, 3.8 cm in intrapulmonary ones. Chondroid components were present in 11(65%) of 17 endobronehial ones but in 30(91%) of 33 intrapulmonary hamartomas. No malignant changes were seen perioperative period and up to early 1993. Conclusion: The younger age in endobronchial hamartomas, the preponderance of the female sex and the more incidence in the right lung, and the diagnostic choice of lobectomies were different from the studies of the Western countries.

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The Length of Postoperative Antituberculous Therapy in Patients with Pulmonary Tuberculosis (폐결핵 환자의 폐절제술 후 항결핵제 투여기간)

  • Kwon, Eun-Su;Song, Jin-Ho;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.421-431
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    • 2000
  • Background : The length of postoperative drug therapy remains controversial in pulmonary tuberculosis. We analyzed our experiences to determine the postoperative duration of chemotherapy after resection. Method : A retrospective review was performed in 66 of 95 patients that underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1998. We compared the relapse rates according to the length of postoperative chemotherapy in each group, classified by the results of sputum AFB culture before the surgery, the number of resistant drugs, the number of prior treatment and the division of anti-TB drugs used postoperatively. Results : Fifty three of 66(80.3%) were men and 13(19.7%) were women with a median age of 33.5 years(range, 16 to 63). The mean lengths of the pre- and post-operative chemotherapies were 4.9 months, and 12.9 months respectively. Five of 66 patients (7.6%) relapsed during the mean period of follow up (39.7 months). In the group less than three times of the prior treatment, there were two relapses (20%) in Ed-the highlight above-rephrase 10 patients that were medicated for 6 months or less, and one relapse in 43 patients (2.3%) that took medicine for more than 6 months (p=0.03). In the group using second-line drugs postoperatively, there was one relapse (25%) in four patients that were medicated for 12 months or less. No patient in a total of 17 that received medicine for more than 12 months relapsed (p=0.03). Conclusion : We recommend that patients with the prior treatment less than three times should be treated for more than 6 months after resection and patients using the second-line drugs postoperatively should be medicated for more than 12 months.

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Two Cases of Hot Tub Lung in Bodyscrubbers Working in a Public Bath (대중목욕탕 근무 후 발생한 온수 욕조 폐 2예)

  • Bak, Ji Young;Kim, Kwang Sil;Park, I-Nae;Yum, Ho-Kee;Lee, Seung Heon;Lee, Hyun-Kyung;Lee, Young Min;Jung, Hoon;Hur, Jin-Won;Lee, Seong Soon;Lee, Hyuk Pyo;Choi, Soo Jeon;Shin, Eun Ah;Choi, Sang Bong
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.37-41
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    • 2009
  • Hot tub lung has been described as a pulmonary illness associated with exposure to nontuberculous mycobacteria,mainly hot bathtub water contaminated with Mycobacterium avium complex (MAC) and hence the name. Although not entirely clear, its etiology has been thought to involve either an infection or a hypersensitivity pneumonitis secondary to MAC. Herein, we describe 2 female patients (60 and 53 years old) admitted to our hospital with hot tub lung, and both of whom worked in a public bath. Both women were initially admitted following several months of exertional dyspnea and cough. The patients had been working as body-scrubbers in a public bath for several years. Their chest CT scans showed bilateral diffuse ground-glass opacities with multifocal air-trappings and poorly defined centrilobular nodules in both lungs. Pathological findings from lung specimens revealed small non-necrotizing granuloma in the lung parenchyme with relatively normal-looking adjacent alveoli. Discontinuation of working in the public bath led to an improvement in symptoms and radiographic abnormalities, without antimycobacterial therapy.

A Comparison of Conventional Cytology and ThinPrep Cytology of Bronchial Washing Fluid in the Diagnosis of Lung Cancer (폐암의 진단 검사 중 기관지 세척액에서 ThinPrep검사법과 기존의 세포검사법의 유용성에 대한 비교)

  • Kim, Sang-Hoon;Kim, Eun Kyung;Shi, Kyeh-Dong;Kim, Jung-Hyun;Kim, Kyung Soo;Yoo, Jeong-Hwan;Kim, Joo-Young;Kim, Gwang-Il;Ahn, Hee-Jung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.523-530
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    • 2007
  • Background: A ThinPrep$^{(R)}$ Processor was developed to overcome the limitations of conventional cytology and is widely used to diagnose various cancers. This study compared the diagnostic efficacy of conventional cytology for lung cancer with that of the ThinPrep$^{(R)}$ cytology using the bronchial washing fluid. Methods: The bronchial washing fluid of 790 patients from Jan. 2002 to Dec. 2006, who were suspected of gaving a lung malignancy, was evaluated. Both ThinPrep$^{(R)}$ and conventional cytology were performed for all specimens. Result: Four hundred forty-six men and 344 women were enrolled in this study, and 197 of them were diagnosed with cancer from either a bronchoscopic biopsy or a percutaneous needle aspiration biopsy. ThinPrep$^{(R)}$ cytology showed a sensitivity, specificity, positive predictive value, negative predictive value and false negative error rate of 71.1%, 98.0%, 92.1%, 91.1%, 8.9%, respectively. The conventional cytology showed sensitivity, specificity, positive predictive value, nagative predictive value and false negative error rate of 57.9%, 98.0%, 90.5%, 87.5%, 12.5%, respectively. For central lesions, the sensitivity of conventional cytology and ThinPrep$^{(R)}$ were 70.1% and 82.8%, respectively. Conclusion: ThinPrep$^{(R)}$ cytology showed a higher sensitivity and lower false negative error rate than conventional cytology. This result was unaffected by the histological classification of lung cancer. Therefore, ThinPrep$^{(R)}$ cytology appears to be a useful method for increasing the detection rate of lung cancer in bronchial washing cytology test.

Correlation between Expiratory Increase of Lung Attenuation and Age and Smoking in the Subjects with Normal Inspiratory Low Dose CT and Pulmonary Function Test (저선량 흉부전산화단층촬영의 흡기 영상과 폐기능이 정상인 성인에서 호기 말 폐 감쇄도 증가 정도와 연령 및 흡연과의 연관성)

  • Kwon, Sung-Youn;Hwang, Yong-Il;Yoon, Ho-Il;Lee, Jae-Ho;Lee, Choon-Taek;Lee, Kyung Won
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.457-463
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    • 2008
  • Background: The attenuation of the lung parenchyma increases on expiration as a consequence of decreased air in the lung. Expiratory CT scans have been used to show air trapping in patients with chronic airway disease and diffuse parenchymal disease and also in asymptomatic smokers. Although there have been several reports investigating the regional air trapping on a expiratory CT scan, there have been only a few reports evaluating the changes of whole lung attenuation with considering its clinical significance, and especially in healthy subjects. The purpose of this study was to evaluate the correlation of an expiratory increase of lung attenuation with age and smoking in healthy subjects. Methods: Asymptomatic subjects who underwent a low dose chest CT scan as part of a routine check-up and who showed normal spirometry and a normal inspiratory CT scan were recruited for this study. We excluded the subjects with significant regional air trapping seen on their expiratory CT scan. Lung attenuation was measured at 24 points of both the inspiratory and expiratory CT scans, respectively, for 100 subjects. The correlations between an expiratory increase of the lung attenuation and the amount of smoking, the patient's age and the results of spirometric test were assessed. Results: There were 87 men and 13 women included in this study. Their median age was 49.0 years old (range:25~71). Sixty current smokers, 24 ex-smokers and 16 non-smokers were included. As age increased, the expiratory increase of lung attenuation was reduced at every measuring points (r=-0.297~-0.487, Pearson correlation). The statistical significance was maintained after controlling for the effect of smoking. Smoking was associated with a reduction of the expiratory increase of lung attenuation. But the significance was reduced after controlling for the patient's age. The $FEV_1$, FVC, $FEV_1/FVC$ and $FEF_{25{\sim}75%}$ were not associated with an expiratory increase of lung attenuation. Conclusion: The expiratory increase of lung attenuation in subjects with a normal inspiratory CT scan was negatively correlated with age. It was also reduced in heavy smokers. It may reflect aging and the smoking related changes.

An Analysis of the National Suicide Rate in Korea during 2005 (2005년 전국 자살실태 분석)

  • Kim, Gi-Jeong;Kwak, Jyung-Sik
    • Journal of forensic and investigative science
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    • v.2 no.1
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    • pp.5-22
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    • 2007
  • From the numerous social problems generated by the unbalanced social development and the social trend of belittling life overall, we found the causes of suicide getting worse in its seriousness day by day. In reality, the problem has been approached in a collateral level in contrast with other social problems. There have been an active involvement in studying the definition, causes and ways of prevention of suicide theoretically until now. However, different from other social problems, it is almost impossible to treat or fix the problem of suicide. Only ways to treat or fix the problem is when the suicide has ended in failure. Thus, this study intends to examine the suicide rate among the total accidents during the year 2005, perform the analyses on the actual causes according to the relations such as the means of suicide, occupation, age group, educational background, etc. In order to present a solution to the issue of suicide becoming serious each day. Among the total accidents in 2005, the suicide rate came out to be approximately 52.4%. Among the result, 52.4%, male with 69% resulted higher than female with 31%, which appears to be related to the social functions. While men tends to take more active(80%) means of suicide like jumping off, poison, hanging, etc., women tends to take more passive(60%) means of suicide like sleeping pills, slitting wrist, etc. In terms of the cause, pessimism, illness, denial, mental disorder, etc resulted more than 75%, and there were many cases of suicide after exhibiting the signs of depression. Also there were higher suicide rate of the unemployed engaged in direct labor with educational background lower than college level related to the pessimism regarding the family living cost. We were able to determine the recent increase in the suicidal tendency of the educated people higher than the college level and the retired people with depression caused by the sudden change in social status. Overall there are several reasons for suicide, however, in most cases the signs of depression were exhibited until the final suicide, which tells us the serious psychological problem of suicide. Assuming that the current development of suicide will continue in future, the result of this study will guide the corresponding social policies, be utilized in preparing the insurance or management at the national level dealing with the real social problems that are not just a conflict of an individual, but could spread like a fad and become much bigger than the present by the continuous support at the environmental, social and political levels, and be utilized as the basic data to establish the research plan.

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Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

Catastrophic Art and Its Instrumentalized Selection System : From work by Hunter Jonakin and Dan Perjovschi (재앙적 예술과 그 도구화된 선별체계: 헌터 조너킨과 댄 퍼잡스키의 작품으로부터)

  • Shim, Sang-Yong
    • The Journal of Art Theory & Practice
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    • no.13
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    • pp.73-95
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    • 2012
  • In terms of element and process, art today has already been fully systemized, yet tends to become even more systemized. All phases of creation and exhibition, appreciation and education, promotion and marketing are planned, adjusted, and decided within the order of a globalized, networked system. Each phase is executed, depending on the system of management and control and diverse means corresponding to the system. From the step of education, artists are guided to determine their styles and not be motivated by their desire to become star artists or running counter to mainstream tendency and fashion. In the process of planning an exhibition, the level of artist awareness is considered more significant than work quality. It is impossible to avoid such systems and institutions today. No one can escape or be freed from the influence of such system. This discussion addresses a serious distortion in the selection system as part of the system connotatively called "art museum system," especially to evaluate artistic achievement and aesthetic quality. Called "studio system" or "art star system," the system distinguishes successful minority from failed absolute majority and justifies the results, deciding discriminative compensations. The discussion begins from work by Hunter Jonakin and Dan Perjovschi. The key point of this discussion is not their art worlds but the shared truth referred by the two as the collusive "art market" and "art star system." Through works based on their experiences, the two artists refer to these systems which restrict and confine them. Jonakin's Jeff Koons Must Die! is avideo game conveying a critical comment on authoritative operation of the museum system and star system. In this work, participants, whether viewer or artist, are destined to lose: the game is unwinnable. Players take the role of a person locked in a museum where artist Jeff Koons' retrospective is held. The player can either look around and quietly observe the works, which causes a game-over, or he can blow the classical paintings to pieces and cause the artist Koons to come out and reprimand the player, also resulting in a game-over. Like Jonakin, Dan Perjovschi's some drawings also focuses on the status of the artist shrunken by the system. Most artists are ruined in a process of competition to survive within the museum system. As John Burger properly pointed out, out of the art systems today, public collections (art museums) and private collections have become "something unbearable." The system justifies the selection system of art stars and its frame of reference, disregarding the problem of producing numerable victims in its process. What should be underlined above all else is that the present selection system seriously shrinks art's creative function and its function of generating meaning. In this situation, art might fall to the level of entertainment, accessible to more people and compromising with popularity. This discussion is based on assumption and consciousness on the matter that this situation might cause catastrophic results for not only explicit victims of the system but also winners, or ones defined as winners. The system of art is probably possible only by desire or distortion stemmed from such desire. The system can be flourished only under the economic system of avarice: quantitatively expanding economy, abundant style, resort economy in Venice and Miami, and luxurious shopping malls with up-to-date facilities. The catastrophe here is ongoing, not a sudden emergence, and dynamic, leading the system itself to a devastating end.

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The Correlation between the Number of Fungiform Papillae and Electrogustometric Thresholds in Adults (젊은 성인에서 심상유두개수와 전기미각역치의 상관성)

  • Han, Dong-Hoon;Park, Ji-Il;Lim, Hoi-Soon;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.1-10
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    • 2011
  • The aims of this study were to establish the effect of gender and age on number of fungiform papillae and electrogustometric thresholds of the tongue, and to determine the relation between number of fungiform papillae and electrogustometric threshold. Sixty-two healthy subjects of 20 to 39 years old were enrolled in this study. Examination areas were defined as center, anterior, left lateral, right lateral, and posterior on the dorsal surface of the tongue, which was stained with methylene blue dye and photographed with a scale bar on it. The number of fungiform papillae within $1\; cm^2$ square area of each examination site was counted twice. The counted values were averaged to produce means. Taste thresholds were measured three times on each examination area using an electrogustometer. Means of the threshold values were calculated. 1. The number of fungiform papillae was the largest at the anterior examination area, followed by right lateral, left lateral, posterior and central. Women had more fungiform papillae than men at anterior, right lateral, and center areas. Subjects in twenties showed more fungiform papillae than those in thirties at anterior, right lateral, and left lateral areas. 2. Anterior area of the tongue measured the lowest electrogustometric threshold, followed by left lateral, right lateral, posterior and center. The threshold was higher in men at anterior and right lateral areas. The subjects in thirties had higher threshold only at right lateral area than those in twenties. 3. Electrogustometric threshold was inversely correlated with the number of fungiform papillae at anterior and posterior areas. The results showed that the number of fungiform papillae and taste threshold varied according to tongue locus, and they were influenced by age and gender. The results also suggested that the number of fungiform papillae was related to electrogustometric threshold inversely.

The Effects of Transcutaneous Electric Nerve Stimulation (TENS) on the EMG Power Spectrum and Pressure Pain Threshold (PPT) (경피성 신경자극이 근전도 Power Spectrum과 압력통각역치에 미치는 영향)

  • Kim, Cheul;Park, Moon-Soo
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.403-411
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    • 2007
  • This investigation was carried out to evaluate the effect of Transcutaneous Electric Nerve Stimulation (TENS) to experimentally induced masticatory muscle pain and muscular fatigue. Twenty-nine healthy volunteers (18 men and 11 women, aged $26.1{\pm}4.7$ years) without past history or present symptoms of temporomandibular disorders were participated in this study. All of the subjects were randomly assigned to experimental group and control group, after at least 3 days interval, two groups were reassigned conversely. Subjects assigned to experimental group were received TENS and others assigned to control group were received sham-TENS therapy for 45 minutes, respectively. The changes of Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT), and EMG power spectrum were measured on the masseter muscle both before and after sustained fatiguing contraction in each group. The major findings of this study are as follows : 1. PPTs and median frequencies of masseter muscles were significantly decreased after sustained isometric contraction resulting in muscular fatigue. 2. In experimental group received TENS therapy, PPTs measured both before and after occurrence of experimentally induced muscular fatigue were significantly increased. 3. In experimental group received TENS therapy, the changes of PPTs during sustained isometric contraction resulting in muscular fatigue were significantly decreased. 4. In experimental group received TENS therapy, VAS measured after occurrence of experimentally induced muscular fatigue was significantly decreased. 5. Although there were not statistical significances, endurance time was increased in experimental group received TENS therapy and decreased in control group received sham-TENS therapy. 6. In experimental group received TENS therapy, the changes of median frequencies were the less decreased and the slope of median frequency shift was the more increased during endurance time than in control group, however, there were not statistical significances.