• Title/Summary/Keyword: lung retention

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Treatment of Occult Bronchial Foreign Body with 30-Year Retention - A case report - (30년간 잠복한 기관지 내 이물의 치험 - 1예 보고 -)

  • Choi, Jae-Sung;Kim, Eung-Joong
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.667-670
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    • 2008
  • Occult bronchial foreign bodies are rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. Treatment guidelines, according to the severity of the bronchial or lung parenchymal damage and the duration of foreign body retention, have not been established. A 40-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobe collapse and obstructive pneumonitis as evidenced by imaging studies. He had aspirated the cap of a felt-tipped pen 30 years before presentation, which was unrevealed until his medical history was carefully reviewed during this episode. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. This case added important information to our body of knowledge concerning the various clinical features of occult bronchial foreign bodies.

Mucociliary Clearance in the Children with Bronchial Asthma (기관지 천식 환아에서의 점액섬모 청소율(Mucociliary Clearance))

  • Lee, Myung-Hyun;Sun, Yong-Han;Nam, Seung-Gon;Koh, Young-Yull;Chung, June-Key
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.173-181
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    • 1996
  • Background : Several studies have suggested that impaired mucociliary clearance plays a role in the pathophysiology of bronchial asthma. Cough productive of mucoid sputum is common, and mucous plugs in the airways are frequently observed. These clinical features are in keeping with the histologic lesions of asthma, which involve primarily the epithelial and mucous-producing structures of the conducting airways. Some studies have shown that the mucociliary clearance is impaired in adult asthma, but it has not been studied in childhood asthma. The objectives of this study were to examine whether the mucociliary clearance is impaired in childhood asthma and to estimate the degree of impairment in comparison with that of immotile cilia syndrome. Method : Thirteen children with mild stable asthma and eight patients with immotile cilia syndrome completed this study. Ten healthy children were recruited as a normal control group. The whole-lung mucociliary clearance was measured by the radioaerosol technique. Aerosols, tin colloid particles tagged with the radionuclide technetium-99m($^{99m}Tc$), were generated by means of nebulizer, and inhaled via a mouthpiece. The retention of radioactivity was measured at 30, 60, 90 and 120 minutes by gamma camera, and mucociliary clearance was calculated as percent retention at each time. Results: 1) In each subject, the percent retention decreased variably with the lapse of time. 2) The percent retention of radionuclide decreased at each time in order of normal control, bronchial asthma and immotile cilia syndrome and the percent retention of immotile cilia syndrome was significantly higher than that of normal control at each time(p<0.05). 3) At two hours, the percent retention of bronchial asthma($65.0{\pm}1.8$(SE)%) was significantly higher than that of the normal control($54.4{\pm}3.5%$, p<0.05), and significantly lower than that of immotile cilia syndrome($73.3{\pm}1.4%$, p<0.01). 4) When the percent retention was analyzed according to $PC_{20}$ in the children with bronchial asthma, they had no relationship with each other. Conclusion: Mucociliary clearance in the children with bronchial asthma was significantly lower than normal control. This finding indicates that impaired mucociliary clearance operates in childhood asthma as well, and suggests that it may be one contributing factor in the pathogenesis of asthma. The degree of impairment, however, was not so severe as immotile cilia syndrome.

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RNAi-based Knockdown of Multidrug Resistance-associated Protein 1 is Sufficient to Reverse Multidrug Resistance of Human Lung Cells

  • Shao, Shu-Li;Cui, Ting-Ting;Zhao, Wei;Zhang, Wei-Wei;Xie, Zhen-Li;Wang, Chang-He;Jia, Hong-Shuang;Liu, Qian
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10597-10601
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    • 2015
  • Up-regulation of multidrug resistance-associated protein 1 (MRP1) is regarded as one of the main causes for multidrug resistance (MDR) of tumor cells, leading to failure of chemotherapy-based treatment for a multitude of cancers. However, whether silencing the overexpressed MRP1 is sufficient to reverse MDR has yet to be validated. This study demonstrated that RNAi-based knockdown of MRP1 reversed the increased efflux ability and MDR efficiently. Two different short haipin RNAs (shRNAs) targeting MRP1 were designed and inserted into pSilence-2.1-neo. The shRNA recombinant plasmids were transfected into cis-dichlorodiamineplatinum-resistant A549 lung (A549/DDP) cells, and then shRNA expressing cell clones were collected and maintained. Real time PCR and immunofluorescence staining for MRP1 revealed a high silent efficiency of these two shRNAs. Functionally, shRNA-expressing cells showed increased rhodamine 123 retention in A549/DDP cells, indicating reduced efflux ability of tumor cells in the absence of MRP1. Consistently, MRP1-silent cells exhibited decreased resistance to 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and DDP, suggesting reversal of MDR in these tumor cells. Specifically, MRP1 knockdown increased the DDP-induced apoptosis of A549/DDP cells by increased trapping of their cell cycling in the G2 stage. Taken together, this study demonstrated that RNAi-based silencing of MRP1 is sufficient to reverse MDR in tumor cells, shedding light on possible novel clinical treatment of cancers.

The Effect of Ipidural Pain Block After Thoracotomy (개흉술후 지속적 경막외마취가 통증감소에 미치는 영향)

  • 최덕영;원경준
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.809-814
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    • 1997
  • Continuous epidural pain block with a local anesthetic agents is a commonly employed technique for pain relief after thoracotomy. In this study, we evaluated the effectiveness of the continuous epidural pain block in 19 patients undergoing elective lateral or posterolatrral thoracotomy with control group(n=19) from November 1994 to July 1995, Epidural lidocaine and morphine mixtures were injected via an epidural catheter as a bolus after operation, and then bupivacaine and morphine mixtures were injected continuously following 5 or 6 days. The pain score, upper arm elevation(ROM score), and respiratory rate were significantly changed(P<0.05) from 30min after injection. The CO2 tension of arterial blood was decreased significantly(P<0.05) from 2hr after injection. The postoperative hospital days were decreased significantly(P<0.05). Side effects of the epidural pain block were urinary retention(n= 10), urticaria(n=2) and a case of headache. There was no postoperative lung atelectasis. We conclude that the continuous epidural pain block is good for prevention of the postoperative lung complication and early recovery after thoracotomy.

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FDG Uptake and a Contrast Enhancement According to Histopathologic Types in Lung Cancers (폐암의 조직학적 분류에 따른 종양의 FDG 섭취와 CT 조영증강정도에 관한 연구)

  • Han, You-Mie;Choe, Jae-Gol;Kim, Young-Chul;Park, Eun-Kyung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.19-25
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    • 2009
  • Purpose: The aims of this study were to analyze correlation between the maximum standardized uptake value (SUVmax) of 2-[F-18]-fluoro-2-deoxy-d-glucose (FDG) on positron emission computed tomography (PET-CT) scan and the degree of contrast enhancement on computed tomography (CT) scan in lung cancers, and to recognize the difference in SUVmax and CT enhancement between groups of different histopathologic subtypes. Materials and Methods: Our study included 53 patients of pathologically confirmed primary lung cancer, who were performed PET-CT and post-contrast chest CT. We calculated initial and delayed SUVmax (SUV1, SUV2), difference between SUV1 and SUV2 (SUVd), retention index (RI), and the degrees of CT contrast enhancement of lung cancers. We analyzed these variables for subtypes of lung cancers. Results: The values (mean$\pm$ standard deviation) were $8.3{\pm}4.4$ for SUV1, $10.7{\pm}5.7$ for SUV2, $2.4{\pm}1.6$ for SUVd, $30{\pm}14$ for RI and $47.1{\pm}14.8$ HU (Hounsfield Unit) for degree of CT contrast enhancement. The difference of SUV1 and degree of CT enhancement between subtypes was not meaningful. SUV1 showed positive correlations with SUVd (r=0.74, p<0,01) and tumor size (r=0.58, p<0.01), but no significant correlation with degree of CT enhancement (r=0.06, p=0.69). In 10 cases, there was discrepancy in the same mass between the area of highest FDG-uptake and the area of highest contrast enhancement. Conclusion: We suggest that FDG uptake in lung cancer does not have a positive linear correlation with degree of CT enhancement. And there is no significant difference in FDG uptake and degree of CT enhancement between different subtypes of lung cancers.

A Study on the Response Differences to the Sasang Constitution Questionnaire by Sasang Constitutions in High School Girls with Menstrual Disorders (월경장애 여고생을 대상으로 환자용 사상체질진단 설문지의 체질별 응답차이 연구)

  • Jeon, Soo-Hyung;Kim, Kyu-Kon;Lee, In-Seon
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.161-170
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    • 2015
  • Objectives The purpose of this study was to investigate whether the menstrual disorders affect the Sasang constitutions questionnaire response in high school girls. Methods Using a structured menstrual history questionnaire, we evaluated the degree of menstrual disorders of 795 high school girls who participated in this clinical trial. Based on the survey we classified them into menstrual disorders group and control group. They filled out SSCQ-P (Sasang Constitution Questionnaire for Patients) and we had compared the difference in response by Sasang constitutions. Each group included 97 girls respectively. From 68 girls in menstrual disorders group and 81 girls in control group, 149 questionnaire was analyzed statistically by their constitutions. Results Four questions in Soyangin, twenty one questions in Taeeumin, ten questions in Soeumin were statistically significant in response between menstrual disorders group and control group. Conclusions Soyangin's menstrual disorders don't have a significant impact on SSCQ-P survey. Water retention of PMS may be affect divergence of lung and cause various symptoms in Taeeumin. Soeumin's menstrual disorders may be more affect negative emotions and activity decrease than other constitutions.

A Study on etiological factors, symptoms of a disease, and treatments of obesity based on Dong-Yi Bo Gam (동의보감(東醫寶鑑)을 위주(爲主)로한 비만의 원인(原因), 증상(症狀), 치료법(治療法) 연구)

  • Kim, Seok;Jin, Seng-Hee;Kim, Tae-Hee
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.125-136
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    • 1998
  • This study is on the etiological factors of the obesity, symptoms of a disease caused by the etiological factors and the method of medical treatment resulted from symptoms of a disease, it is based on Dong-Yi Bo Gam. The conclusion of this study is as follows. 1. The final metabolic of fat is depend on the defensive energy. The shape of fatty layer is changed by the point where the defensive energy is replenish or not. So 'Goin(暠人)' 'Bein(肥人)' and 'Yuckin(肉人)' is made a discriminated and there is defferent between 'Besudaeso(肥瘦大小)' and 'Herlqidaso(血氣多少)'. 2. Etiological factors of obesity is ; essential substance from cereals overcome the primodial energy, spleen and stomach are strong at once, spleen and stomach are weak at once, spleen is disturbed by evil energy, retention of phlegm and fluid, muscle is weak, blood is excess but energy (qi)is weak, hua-sid(華食) eating the sweat food very often, a rich fatty diet. 3. To investigate each syndrome as etiological factons, essential substance from cereals overcome primodial energy is divided into two case: one is the food increase itself because of the weakness of stomach energy (qi), the other is not to digest the food because liver overact spleen by seven emotion. The obesity because of strengthen of the spleen and stomach at once do not feel hungry very well and spleen and stomach do not damaged easily by overacting. The obesity because of weakness of spleen and stomach at once, and disturbace in spleen cause by evil energy, gain the weight even if they eat food a little. Also it is hard to move four limbs. Weakness of muscle is weakness of spleen and stomach. Weakness of muscle is caused by weakness of spleen and stomach. That is the case of faining the weight because of eating food with an empty stomach. The obsity caused by retention of fluid has intestine rumbling and gain the weight suddenly. 4. The method of medical treatment fallowing to the etiological factors: The food is inclined to increase itself caused by weakness of stomach energy, In case of the obseity caused by this phenomenon. We can use Decoction for Reinforcing Middle wanner and Replenishing Qi(補中益氣湯), five tastes il-going-san(左味異功散) and so on. The method of medical treatment on obsity caused by strengthen of spleen and stomach is not referred yet. But we must investigate about using peptic powder(平胃散), ji-chul-huan(枳朮丸) for strengthen of stomach qi (胃氣). If the obesity appear caused by weakness of spleen and stomach and disturbance in spleen as to evil energy, and in the same time stomach qi is weak, we can use li-gong san(異功散). If not only obesity but also indigestion, we can use Decoction for naurishing the stomach and promotion eating(養胃進食湯). If not only obesity but also weakness of spleen and stomach, we can use Decoction for Reinforcing Middle warmer and replenishing Qi(補中益氣湯). The energy being weak, we can use Decoction for six noble drugs(六君子湯). If the obesity appear because of retention of fluid, we can use sin-chul-huan(神朮丸). On the obesit, caused by excess of blood and weakness of qi(血管氣虛), there is not method of mectical treatment yet, but the method of medical treatment that we count of first important maybe to invigorate the spleen and the lung qi and to disperse and recitify the depressed liver energy(疏肝利氣). The method of medical treament about the obesity caused by a rich fatty diet is not mentioned yet, but it is important to improve the lifestyle of food and we think that invigorate the spleen, and the lung-qi(補疏肝氣) and disperse and recitify the depressed liver-energy (??肝利機) amy count of first important. 5.There is useful medicine for weight down for example Herb tea(茶), red bean, wax gourd, etc. 6.The etiological factors of the obesity that revive frequently is weakness of qi(氣虛), from 形成氣衰, deficiency of yang, hasty of qi, damp and so on. The symptoms and sign of a disease that revive frequently to the obesity is appoplexia(中風), leucorrhea, reddish and whitish turbid, feeling of fullness in the upper abdomen, diabetes and so on.

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Thallium-201 SPECT in Differential Diagnosis of Malignancy from Benign Pathology in Patients with a Solitary Pulmonary Lesion (단일 폐병변에서 T1-201 SPECT를 이용한 악성 종양의 감별진단)

  • Ahn, Byeong-Cheol;Lee, Jae-Tae;Chun, Kyung-Ah;Kim, Dong-Hwan;Sohn, Sang-Kyun;Kim, Chang-Ho;Park, Jae-Yong;Jeong, Tae-Hoon;Lee, Kyu-Bo;Kim, Chun-K.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.143-150
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    • 1998
  • Purpose: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesion in a population with a high prevalence of benign pulmonary lesion, especially, tuberculosis. Materials and Methods: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergil-loma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B- early L/B) $\div$ early L/B]. Results: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions were also visually positive on both images. Although a statistically significant difference was found between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. Conclusion: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.

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Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形) (藏府와 身形의 病機 및 病症에 대한 比較考察)

  • Baek, Sang-Ryong
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.21-21
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exegenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usuable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki)穀氣) 내 that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Maridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily froms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and connot fulfil their own functions. Because the meridian symtem unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.

Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形) (장부(藏府)와 신형(身形)의 병기(病機) 및 병증(病症)에 대한 비교고찰(比較考察))

  • Baek, Sang-Ryong
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.22-42
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exogenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki(穀氣) so that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Meridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily forms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and cannot fulfil their own functions. Because the meridian system unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.

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