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The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

  • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.671-682
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    • 1996
  • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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Postmastectomy Radiotherapy and Chemotherapy in Patients with Breast Cancer (유방절제술을 시행한 유방암 환자에서 방사선과 항암제 치료성적)

  • Ahn Sung-Ja;Chung Woong-Ki;Nam Taek-Keun;Nah Byung-Sik;Song Ju-Young;park Seung-Jin
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.17-24
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    • 2004
  • Purpose: To evaluate the treatment outcomes after postmastectomy radiotherapy (PMRT) and chemotherapy in patients with breast cancer. Materials and Methods: The PMRT were retrospectively analyzed in 83 patients with stage II-III female breast cancer treated between 1989 and 1995. The median age was 46 years (range, 23-77): Seventy-seven patients had modified radical mastectomies, 5 radical mastectomies and 1 simple mastectomy. Three patients ($4\%$) had pathologically negative axillae, and the remaining 80 ($96\%$) had positive axillae. Eleven, 23, 44 and 5 patients had pathological stages IIA, IIB, IIIA, and IIIB, retrospectively. Eighty ($96\%$) patients were treated with hockey-stick fields. The median dose of PMRT was 50.4 ey, in 1.8 Gy fractions. Adjuvant systemic chemotherapy was given to 74 patients ($89\%$). CMF-based or doxorubicin-containing regimens were given to 54 patients ($55\%$). The median follow-up time was 82 months (range, 8-171) after the mastectomy. Results: The 5 and 10-year overall survival rates for all patients were 65 and $49\%$, respectively. The univariate and multivariate analyses of the factors affecting the overall survival revealed the stage to be the most significant prognostic factor (p=0.002), followed by the combination of chemotherapy. Thirteen patients $16\%$ developed a LRF, at an interval of 4-84 months after radiotherapy, with a median of 20 months. The only significant prognostic factor affecting LRF was the combination of chemotherapy, in both the univariate and multivariate analyses. With respect to the sequence of chemoradiation, the sequence had no saatistical significance (p=0.90). According to the time interval from mastectomy to the onset of radiotherapy, the LRFR of the patients group treated by RT within or after 6 month postmastectomy 6 months were 14 vs. $27\%$ respectively (p=0.24). One third of the pa41en1s (26/83) developed distant metastasis, in 2-92 months, after radiotherapy, with a median of 21 months. The most commonly involved site was bone in 13 cases. The pathological staging was the only significant prognostic factor in both the univariate and multivariate analyses that affected distant failure. Radiological finding of radiation pneumonitis on a simple chest x-ray was shown in $20\%$ (17/83), with a time interval ranging from 2 to 7 months post-radiotherapy, with a median of 3 months. The stable lung fibrosis settled in 11 patients ($65\%$). Conclusion: It was concluded through this analysis that the combination of PMRT with in chemotherapy resulted in better overall survival and local control than PMRT alone in patients needing PMRT.

The Results of Hyperfractionated Radiotherapy on Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포 폐암에 대한 과분할 방사선 치료의 성적)

  • Hur, Won-Joo;Lee, Hyung-Sik;Kim, Jeong-Ki;Choi, Young-Min;Lee, Ho-Jun;Youn-Seon-Min;Kim, Jae-seok;Kim, Hyo-Jin;Woo-Jong-Soo;Choi, Pill-Jo;Lee, Ki-Nam
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.275-282
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    • 1998
  • Purpose : The effect of hyperfractionated radiotherapy on locally advanced non-small lung cancer was studied by a retrospective analysis. Materials & Methods : We analyzed sixty one patients of biopsy-confirmed, IIIA and IIIB non-small cell lung cancer. Using the ECOG performance scale, all the patients were scored less than 2. They were treated by curative hyperfractionated radiotherapy alone from Oct. 1992 to Oct. 1995 at the Department of Radiation Oncology. All the patients received 120cGy b.i.d with more than 6 hours interval between each fraction. The total dose of radiation was reached up to 6400-7080 cGy with a mean dose of 6934 cGy. The results were analyzed retrospectively. Results : The overall survival rate was 53 1$\%$ in 1 year, 9.9$\%$ in 2 years with a median survival time (MST) of 13.9 months. The progression free survival (PFS) rate was 37.0$\%$ in 1 year, 8.9$\%$ in 2 years. Twenty two Patients were classified as complete responders to this treatment and their MST was 19.5 months When this was compared with that of partial responders (MST: 11 7months), it was statistically significant (p=0.0003). Twenty nine patients of stage IIIA showed a better overall survival rate (1yr 63.3$\%$, 2yr 16.8$\%$) than IIIB patients (1yr 43.3$\%$, 2yr 3.6$\%$), which was also statistically significant (p=0.003). Patients with adenocarcinoma showed a better survival rate (1yr 64.3$\%$, 2yr 21.4$\%$) than that of squamous cell counterpart (1yr 49.4$\%$, 2yr 7.4$\%$), although this was not significant statistically (p=0.61). Two patients developed fatal radiation-induced pneumonia right after the completion of the treatment which progressed rapidly and they all died within 2 months. One patient developed radiation-induced fibrosis after 13 months. He refused further treatment and died soon after the development of fibrosis. Conclusion : Among locally advanced NSCLC, hyperfractionated radiotherapy was effective on stage IIIA patients by increasing MST with acceptable toxicities. Acute radiation-induced pneumonia should be carefully monitored and must be avoided during or after this treatment.

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Two Anhydrous Zeolite X Crystal Structures, $Ca_{18}Tl_{56}Si_{100}Al_{92}O_{384}\;and\;Ca_{32}Tl_{28}Si_{100}Al_{92}O_{384}$ (제올라이트 X의 두 개의 무수물 $Ca_{18}Tl_{56}Si_{100}Al_{92}O_{384}$$Ca_{32}Tl_{28}Si_{100}Al_{92}O_{384}$의 결정구조)

  • Choi, Eun Young;Kim, Yang
    • Journal of the Korean Chemical Society
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    • v.43 no.4
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    • pp.384-385
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    • 1999
  • Two anhydrous crystal structures of fully dehydrated, $Ca^{2+}$- and $Tl^+$-exchanged zeolite X, TEX>$Ca_{18}Tl_{56}Si_{100}Al_{92}O_{384}($Ca_{18}Tl_{56}$-X;\alpha=24.883(4)\AA)$ and TEX>$Ca_{32}Tl_{28}Si_{100}Al_{92}O_{384}($Ca_{32}Tl_{28}$-X;\alpha=24.973(4)\AA)$ per unit cell, have been determined by single-crystal X-ray diffraction techniques in the cubic space group Fd3 at $21(1)^{\circ}C.$ $Ca_{18}Tl_{56}-X$ was prepared by ion exchange in a flowing stream of 0.045 M aqueous $Ca(NO_3)_2$ and 0.005 M $TlNO_3$. $Ca_{32}Tl_{28}-X$ was prepared similarly using a mixed solution of 0.0495 M $Ca(NO_3)_2$ and 0.0005M $TlNO_3$. Each crystal was then dehydrated at 360 $^{\circ}C$ and $2{\times}10^{-6}$ Torr for 2 days. Their structures were refined to the final error indices, $R_1=0.039\;and\;R_2=0.036$ with 382 reflections for $Ca_{18}Tl_{56}-X$ , and $R_1=0.046\;and\;R_2=0.045$ with 472 reflections for $Ca_{32}Tl_{28}$-X for which $/>3\sigma(I).$ In the structures of dehydrated $Ca_{18}Tl_{56^-}X\;and\;Ca_{32}Tl_{28}$-X, $Ca^{2+}\;and\;Tl^+$ ions are located at six crystallographic sites. Sixteen $Ca^{2+}$ ions fill the octahedral sites I at the centers of double six rings ($Ca_{18}Tl_{56}$-X:Ca-O=2.42(1) and O-Ca-O=93.06(4)$^{\circ}$; $Ca_{32}Tl_{28}$-X Ca-O=2.40(1) $\AA$ and O-Ca-O=93.08(3)$^{\circ}$). In the structure of $Ca_{18}Tl_{56}$-X, another two $Ca^{2+}$ ions occupy site II (Ca-O=2.35(2) $\AA$ and O-Ca-O=111.69(2)$^{\circ}$) and twenty six $Tl^+$ ions occupy site II opposite single six-rings in the supercage; each is 1.493 $\AA$ from the plane of three oxygens $(Tl-O=2.70(8)\AA$ and O-Tl-O=92.33(4)$^{\circ}$). About four $Tl^+$ ions are found at site II',1.695 $\AA$ into sodalite cavity from their three oxygen plane (Tl-O=2.81 (1) and O-Tl-O=87.48(3)). The remaining twenty six $Tl^+$ ions are distributed over site III'(Tl-O=2.82 (1) $\AA$ and Tl-O=2.88(3)$^{\circ}$). In the structure of $Ca_{32}Tl_{28}$-X, sixteen $Ca^{2+}$ ions and fifteen $Tl^+$ ions occupy site III' (Ca-O=2.26(1) $\AA$ and O-Ca-O=119.14(4)$^{\circ}$; Tl-O=2.70(1) $\AA$ and O-Tl-O=92.38$^{\circ}$) and one $Tl^+$ ion occupies site II'. The remaining twelve $Tl^+$ ions are distributed over site III'. It appears that $Ca^{2+}$ ions prefer sites I and II in that order and $Tl^+$ ions occupy the remaining sites.

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Lower Lung Field Tuberculosis (폐 하야 결핵)

  • Moon, Doo-Seop;Lim, Byung-Sung;Kim, Yeon-Soo;Kim, Seong-Min;Lee, Jae-Young;Lee, Dong-Suck;Sohn, Jang-Won;Lee, Kyung-Sang;Yang, Suck-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.232-240
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    • 1997
  • Background : Postprimary pulmonary tuberculosis is located mainly in upper lobes. The tuberculous lesion involving the lower lobes usually arises from the upper lobe cavity through endobronchial spread. When tuberculosis is confined to the lower lung field, it often masquerades as pneumonia, lung cancer, bronchiectasis, or lung abscess. Thus the correct diagnosis may be sometimes delayed for a long time. Methods : We carried out, retrospectively, a clinical study on 50 patients confirmed with lower lung field tuberculosis who visited the Department of Pulmonary Medicine at Hanyang University Hospital from January 1992 to December 1994. The following results were obtained. Results : Lower lung field tuberculosis without concomitant upper lobe disease occurred in fifty patients representing 6.9% of the total admission with active pulmonary tuberculosis over a period of 3 years. It occurred most frequently in the third decade but age distribution was relatively even. The mean age was 43 years old. Female was more frequently affected than male (male to female ratio 1 : 1.9). The most common symptom was cough(68%), followed by sputum(52%), fever(38%), and chest discomfort(30%). On chest X-ray of the 50patients, consolidation was the most common finding in 52%, followed by solitary nodule(22%) collapse(16%), cavitary lesion(10%), in decreasing order. The disease confined to the right side in 25 cases, left side 20 cases, and both sides 5 cases. Endobronchial tuberculosis (1) Endobronchial involvement was proved by bronchoscopic examination in 20 of 50patients. (2) Mean age was 44years old and female was more affected than man (male to female ratio 1 : 3). Sputum AFB stain and Mycobacterium tuberculosis culture were positive only in 50% of cases unlikely upper lobe tuberculosis, additional diagnostic methods were needed. In our study, bronchoscopic examination and percutaneous fine needle aspiration biopsy increased diagnostic yield by 18% and 32%, respectively. The most common associated condition was diabetes mellitus(18%) and others were anemia, anorexia nervosa, stomach cancer, and systemic steroid usage. Conclusion : When we find a lower lung field lesion, we should suspect tuberculosis if the patient has diabetes mellitus, anemia, systemic steroid usage, malignancy or other immune suppressed states. Because diagnostic yield of sputum AFB smear & Mycobacterium tuberculosis culture was low, additional diagnostic methods such as bronchoscopy and fine needle aspiration biopsy were needed.

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A Study on the Preservation of Citrus Mandarin by Irradiation (방사선조사(放射線照射)에 의(依)한 감귤(柑橘) 저장(貯藏)에 관(關)한 연구(硏究))

  • Chung, Chang Cho;Kim, Jai Ha;Kim, Soo Hyun;Cho, Han Ok
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.12 no.2
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    • pp.116-121
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    • 1983
  • A study was conducted to evaluate the effect of $^{60}CO-{\gamma}$ irradiation on the preservation on Satauma mandarin in Cheju Island. Four varieties (S. m. early, S. m. Komezawa, S. m. Hayashi and S. m. Aoshima) were irradiated using 10,000Ci, $^{60}CO-{\gamma}$ ray with dosages of 0, 50, 100 and 150Krad. During 92 days of storage the effects of irradiation on mandarin porperties were as follows: At the end of storage period the accumulated fruit rotting percentage were S. m. Komezawa($T_2$);74.32%, S. m. early($T_1$);69.67%, S. m. Aoshima($T_4$);64.33% and S. m. Hayashi ($T_3$);61.79%. The rottings steadily increased from the early stage of storage and rapid spoilage continued after 59 days of irradiation. A high corelation existed between fruit rotting and varieties ($T_3$;Y=0.78x-15.30, $T_4$;Y=0.79x-12.29, $T_1$;Y=0.93x-9.01 and $T_2$;Y=0.79x-13.49) High dosages(100 and 150 Krad)improved fruit preservation during the mid storage stage. However 76 days after high dose irradiation there was no significant difference a rotting between irradiated fruit and the control. Irradiation decreased acidity of fruit during storage (p<0.01). The mean acidities of examined varieties were $T_1$;1.01%, $T_3$;1.01%, $T_4$;0.84% and $T_2$;0.77%. A significant differences were observed in acidity between varieties and dosages(P<0.01) With one exception in all treatments. the increase in free and total sugar content was not statestically significant. The exception was the 50 Krad treatment where the total sugar content decreased. $T_1$ and $T_4$ showed slightly higher value of than Brix $T_2$ and $T_3$, and were significantly(P<0.01) decreased by higher dosage. The ascorbic acid content in all treatments decreased with length of storage and also decreased significantly with a higher dosage.

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Crystal Structures of Dehydrated Partially $Sr^{2+}$-Exchanged Zeolite X, $Sr_{31}K_{30}Si_{100}A1_{92}O_{384}\;and\;Sr_{8.5}TI_{75}Si_{100}AI_{92}O_{384}$ (부분적으로 스트론튬이온으로 교환되고 탈수된, 제올라이트 X의 결정구조)

  • Kim Mi Jung;Kim Yang;Seff Karl
    • Korean Journal of Crystallography
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    • v.8 no.1
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    • pp.6-14
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    • 1997
  • The crystal structures of $Sr_{31}K_{30}-X\;(Sr_{31}K_{30}Si_{100}A1_{92}O_{384};\;a=25.169(5) {\AA}$) and $Sr_{8.5}Tl_{75}-X (Sr_{8.5}Tl_{75}Si_{100}A1_{92}O_{384};\;a=25.041(5) {\AA}$) have been determined by single-crystal X-ray diffraction techniques in the cubic space group $\=F{d3}\;at\;21(1)^{\circ}C$. Each crystal was prepared by ion exchange in a flowing stream of aqueous $Sr(ClO_4)_2\;and\;(K\;or\;T1)NO_3$ whose mole ratio was 1 : 5 for five days. Vacuum dehydration was done at $360^{\circ}C$ for 2d. Their structures were refined to the final error indices $R_1=0.072\;and\;R_w=0.057$ with 293 reflections, and $R_1= 0.058\;and\;R_w=0.044$ with 351 reflections, for which $I>2{\sigma}(I)$, respectively. In dehydrated $Sr_{31}K_{30}-X,\;all\;Sr^{2+}$ ions and $K^+$ ions are located at five different crystallographic sites. Six-teen $Sr^{2+}$ ions per unit cell are at the centers of the double six-rings (site I), filling that position. The remaining 15 $Sr^{2+}$ ions and 17 $K^+$ ions fill site II in the supercage. These $Sr^{2+}$ and $K^+$ ions are recessed ca $0.45{\AA}\;and\;1.06{\AA}$ into the supercage, respectively, from the plane of three oxygens to which each is bound. ($Sr-O=2.45(1){\AA}\;and\;K-O=2.64(1){\AA}$) Eight $K^+$ ons occupy site III'($K-O=3.09(7){\AA}\;and\;3.11(10){\AA}$) and the remaining five $K^+$ ions occupy another site III'($K-O=2.88(7){\AA}\;and\;2.76(7){\AA}$). In $Sr_{8.5}Tl_{75}-X,\;Sr^{2+}\;and\;Tl^+$ ions also occupy five different crystallographic sites. About 8.5 $Sr^{2+}$ ions are at site I. Fifteen $Tl^+$ ions are at site I' in the sodalite cavities on threefold axes opposite double six-rings: each is $1.68{\AA}$ from the plane of its three oxygens ($T1-O=2.70(2){\AA}$). Together these fill the double six-rings. Another 32 $Tl^+$ ions fill site II opposite single six-rings in the supercage, each being $1.48{\AA}$ from the plane of three oxygens ($T1-O=2.70(1){\AA}$). About 18 $Tl^+$ ions occupy site III in the supercage ($T1-O=2.86(2){\AA}$), and the remaining 10 are found at site III' in the supercage ($T1-O=2.96(4){\AA}$).

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Chest CT findings and Clinical features in Mediastinal Tuberculous Lymphadenitis (종격동 결핵성 임파선염의 흉부전산화 단층촬영 소견과 임상 양상에 대한고찰)

  • Lee, Young-Sil;Kim, Kyeong-Ho;Kim, Chang-Sun;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.481-491
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    • 1995
  • Background: Recently there has been a trend of an increasing incidence of mediastinal tuberculous lymphadenitis(MTL) in adults. MTL often cause bronchial stenosis or esophago-mediastinal fistula. In spite of effective treatment, it is difficult to cure. Moreover, relapse frequently occurs. Authors analyzed chest CT findings and clinical features of 29 cases with MTL Methods: 29 cases with MTL were retrospectively studied with the clinical and radiologic features from April 1990 to March 1995 Results: 1) A total of 29 cases were studied. 12 cases were male and 17 cases were female. The male to female ratio was 1:1.4 Mean age was 29 years old. The 3rd decade(45%) was the most prevalent age group 2) The most common presenting symptoms and signs were palpable neck masses(62%) followed by cough(59%) and sputum(38%) 3) Except in one case of MTL, all patients had coexisting pulmonary tuberculosis, cervical tuberculous lymphadenitis, endobronchial tuberculosis and tuberculous pleurisy. Among the coexisting tuberculous diseases, Pulmonary tuberculosis was the most common(76%) 4) On simple chest X-ray, mediastinal enlargement was noted in 21 cases(72%), but it was not noted in 8 cases(28%). The most frequently involving site was the paratracheal node in 16 cases(72%). Rt side predominence(73%) was noted 5) Patterns of node appearance on a postcontrast CT scan were classified into 3 types. There were 19 cases(30%) of the Homogenous type, 30 cases(47%) of the Central low density type and 15 cases(23%) of the Peripheral fat obliteration type. The most common type was the central low density type. The most common lymph node size was 1~2 cm(88%) 6) The most frequently involved site was the paratracheal node in 26 cases(89%) by chest CT. Rt side(63%) was predominant 7) 9 cases(43%) had complete therapy and most common treatment duration was 13 - 18 months. 12 cases(57%) had incomplete continuing antituberculous medication and half of the cases had been treated above 19 months. Conclusion: Chest CT findings of MTL showed central low density area and peripheral rim enhancement, so this characteristic findings could differentiate it from other mediastinal diseases and help a diagnosis of tuberculosis. In spite of effective antituberculous medication, it is difficult to cure. Moreover, relapse frequently occurs. Further studies will be needed of the clinical features and the treatment of MTL.

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The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

Crystal Structures of Full Dehydrated $Ca_{35}Cs_{22}Si_{100}Al_{92}O_{384}$and $Ca_{29}Cs_{34}Si_{100}Al_{92}O_{384}$ ($Ca^{2+}$ 이온과 $Cs^+$ 이온으로 치환되고 탈수된 두개의 제올라이트 X $Ca_{35}Cs_{22}Si_{100}Al_{92}O_{384}$$Ca_{29}Cs_{34}Si_{100}Al_{92}O_{384}$의 결정구조)

  • Jang, Se Bok;Song, Seung Hwan;Kim, Yang
    • Journal of the Korean Chemical Society
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    • v.40 no.6
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    • pp.427-435
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    • 1996
  • The structures of fully dehydrated $Ca^{2+}$- and $Cs^+$-exchanged zeolite X, $Ca_{35}Cs_{22}Si_{100}Al_{92}O_{384}$($Ca_{35}Cs_{22}$-X; a=25.071(1) $\AA)$ and $Ca_{29}Cs_{34}Si_{100}Al_{92}O_{384}$($Ca_{29}Cs_{34}$-X; a=24.949(1) $\AA)$, have been determined by single-crystal X-ray diffraction methods in the cubic space group Fd3 at $21(1)^{\circ}C.$ Their structures were refined to the final error indices $R_1$=0.051 and $R_2$=0.044 with 322 reflections for $Ca_{35}Cs_{22}$-X, and $R_1$=0.058 and $R_2$=0.055 with 260 reflections for $Ca_{29}Cs_{34}$-X; $I>3\sigma(I).$ In both structures, $Ca^{2+}$ and $Cs^+$ ions are located at five different crystallographic sites. In dehydrated $Ca_{35}Cs_{22}$-X, sixteen $Ca^{2+}$ ions fill site I, at the centers of the double 6-rings(Ca-O=2.41(1) $\AA$ and $O-Ca-O=93.4(3)^{\circ}).$ Another nineteen $Ca^{2+}$ ions occupy site II (Ca-O=2.29(1) $\AA$, O-Ca-O=118.7(4)') and ten $Cs^+$ ions occupy site II opposite single six-rings in the supercage; each is $1.95\AA$ from the plane of three oxygens (Cs-O=2.99(1) and $O-Cs-O=82.3(3)^{\circ}).$ About three $Cs^+$ ions are found at site II', 2.27 $\AA$ into sodalite cavity from their three-oxygen plane (Cs-O=3.23(1) $\AA$ and $O-Cs-O=75.2(3)^{\circ}).$ The remaining nine $Cs^+$ ions are statistically distributed over site Ⅲ, a 48-fold equipoint in the supercages on twofold axes (Cs-O=3.25(1) $\AA$ and Cs-O=3.49(1) $\AA).$ In dehydrated $Ca_{29}Cs_{34}$-X, sixteen $Ca^{2+}$ ions fill site I(Ca-O=2.38(1) $\AA$ and $O-Ca-O=94.1(4)^{\circ})$ and thirteen $Ca^{2+}$ ions occupy site II (Ca-O=2.32(2) $\AA$, $O-Ca-O=119.7(6)^{\circ}).$ Another twelve $Cs^+$ ions occupy site II; each is $1.93\AA$ from the plane of three oxygens (Cs-O=3.02(1) and $O-Cs-O=83.1(4)^{\circ})$ and seven $Cs^+$ ions occupy site II'; each is $2.22\AA$ into sodalite cavity from their three-oxygen plane (Cs-O=3.21(2) and $O-Cs-O=77.2(4)^{\circ}).$ The remaining sixteen $Cs^+$ ions are found at III site in the supercage (Cs-O=3.11(1) $\AA$ and Cs-O=3.46(2) $\AA).$ It appears that $Ca^{2+}$ ions prefer sites I and II in that order, and that $Cs^+$ ions occupy the remaining sites, except that they are too large to be stable at site I.

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