만성 기관지염 및 재발성 급성 호흡기감염 치료에 있어서 경구용 Biostim^(�)에 대한 임상 연구

장중현,이홍렬,장준,김성규 최신의학사 1992 最新醫學 Vol.35 No.7

죽재를 이용한 콘크리트의 사용성에 관한 실험적 연구

鄭熺孝,金洪俊,李承列,黃俊碩 경상대학교 생산기술연구소 2002 工學硏究院論文集 Vol.2 No.-

The purpose of this study is about the possibility of using bamboo to reinforce concrete in comparison with the reinforced concrete in the same experimental condition by conducting concrete using bamboo material and mechanical test of a bamboo. As a substitute material for the reinforced concrete, to check the possibility of using concrete with bamboo material either saving iron resources or developing lighter material was tried. Conclusions of this study can be summarized as follows; In contrast to reinforced concrete, bamboo concrete was failed brittly about cracked state, the failure was occurred by slip between concrete and bamboo before it reached yielding stress of bamboo. In the pullout test, bamboo pullout specimens were crushed by brittle crack and steel bar pullout specimens by pullout failure.

상자형의 전단지연 현상과 유효폭에 관한 연구

鄭熺孝,金洪俊,李承烈,朴峻熙 경상대학교 생산기술연구소 2002 工學硏究院論文集 Vol.2 No.-

In a box girder, it is an accepted practice in structural engineering to represent the effect of 'shear lag' by adopting an 'effective width' concept. The actual width of flange plate (b) is replaced by a reduced width (b_e) over which the longitudinal stresses may be considered uniformly distributed and the application of the elementary theory of bending to the transformed girder cross section gives the correct value of maximum longitudinal stress (σ_max). This paper provides how to determine the magnitude of 'shear lag' and 'effective width ratio' in case of orthotropic box girder which is simply supported, symmetrically loaded only.

Case Reports : A Case of Pulmonary Inflammatory Pseudotumor: Recurrence Appearing as Several Consolidative Lesions after Complete Resection

Hong Lyeol Lee,Lu Cia Kim,Kyung Hee Lee,Kwang Ho Kim,Cheol Woo Kim 대한내과학회 2005 The Korean Journal of Internal Medicine Vol.20 No.2

Implication of GAP model in idiopathic pulmonary fibrosis

( Lee Sang Hoon ),( Dong Soon Kim ),( Young Whan Kim ),( Man Pyo Chung ),( Soo Taek Uh ),( Choon Sik Park ),( Sung Hwan Jeong ),( Yong Bum Park ),( Hong Lyeol Lee ),( Jong Wook Shin ),( Eun Joo Lee ) 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-

Background: Ley et al. demonstrated simple-to-use GAP model for predicting mortality in IPF patients. We investigated prognosis of IPF patients by each total GAP score. Method: The Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of IPF patients from January 1, 2003 to December 31, 2007. A total of 1,685 IPF patients were enrolled in this study. Among them, 1,262 patients performed pulmonary function test including DLco. Results: Patients were stratified into each total GAP score 0~7; GAP score 0 (n = 26); score 1 (n = 150), score 2 (n = 208); score 3 (n = 376); score 4 (n = 317); score 5 (n = 138); score 6 (n = 39); score 7 (n = 8). Patients with total GAP score zero, and seven were excluded in this analysis due to small number. Increased GAP score and advanced GAP stage were associated with a significantly poor prognosis (p < 0.001). In stage I, total GAP score 3 was significantly lower in survival than 1 or 2 groups (p = 0.027 and 0.022, respectively). Compared with stage II, survival of GAP score 3 was significantly superior than 4 or 5 groups (p = 0.025 and 0.001, respectively). Conclusion: Total GAP score 3 group showed significant difference comparing other score groups and showed eventually similar prognosis of patients with GAP stage II. This means that total GAP score 3 group should be divided from stage I group. Further large studies are needed to determine GAP stage divided with total GAP scores for predicting prognosis of IPF patients.

Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 2. Idiopathic Pulmonary Fibrosis

Lee, Sang Hoon,Yeo, Yoomi,Kim, Tae-Hyung,Lee, Hong Lyeol,Lee, Jin Hwa,Park, Yong Bum,Park, Jong Sun,Kim, Yee Hyung,Song, Jin Woo,Jhun, Byung Woo,Kim, Hyun Jung,Park, Jinkyeong,Uh, Soo-Taek,Kim, Young The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.2

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

Multiple Hypercoagulability Disorders at Presentation of Non-Small-Cell Lung Cancer

Lee, Jeong Min,Lim, Jun Hyeok,Kim, Jung-Soo,Park, Ji Sun,Memon, Azra,Lee, Seul-Ki,Nam, Hae-Seong,Cho, Jae-Hwa,Kwak, Seung-Min,Lee, Hong Lyeol,Kim, Hyun-Jung,Hong, Geun-Jeong,Ryu, Jeong-Seon The Korean Academy of Tuberculosis and Respiratory 2014 Tuberculosis and Respiratory Diseases Vol.77 No.1

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.

원발성 폐암에 동반된 과칼슘혈증에 대한 임상적 고찰

이홍렬(Hong Lyeol Lee),박규은(Kyu Eun Park),김세규(Se Kyu Kim),장준(Joon Chang),김성규(Sung Kyu Kim),이원영(Won Young Lee) 대한내과학회 1994 대한내과학회지 Vol.47 No.6

N/A Objectives: The humoral hypercalcemia of malignancy(HHM) describes a very specific clinical syndrome due to the production of a peptide or family of peptide hormones which share sequence homology and functional homology with parathyroid hormone. Patients with HHM account for up to 80 percent of malignancy-associated hypercalcemia. The hypercalcemia in lung cancer is mainly mediated by parathyroid hormone-related protein. Typical patients with HHM had little or no skeletal involvement. Hypercalcemia is predominantly associated with epidermoid and large cell anaplastic carcinoma. From a clinical standpoint, patients with hypercalcemia are usually in advanced stages with obviously bulky tumors and, therefore, carry a poor prognosis. Methods: Between January 1987 and November 1993, the patients those who fulfilled the following criteria were chosen as a subjects in this study: ① corrected serum calcium >10.5mg/dl; ② histologically proven primary lung cancer; ③ symptoms which could possibly be attributed to hypercalcemia. We investigated the various clinical features that could characterize the hypercalcemia in lung cancer. Results: Thirty-one patients with lung cancer were hypercalcemic and most of them had squamous cell carcinoma in histologic finding. The incidence between 50 and 69 years of age was higher significantly. The occurrence of hypercalcemia showed a strong positive correlation with the degree of histologic differentiation and the advancement of cancer stage. And the mean serum calcium level also showed a strong positive correlation with the mass size and the performance scale. Some symtoms such as general weakness, anorexia, constipation, consciousness change, and weight loss were more frequent in the patients of higher calcium level. There was no significant difference in effectiveness among the therapeutic regimens for hypercalcemia. Most of patients were hypercalcemic at the time that the diagnosis of lung cancer was made. Most of them died within 1 month after the development of hypercalcemia. Conclusion: The hypercalcemia in lung cancer was found more frequently in men whose ages were between 50 and 69 years old, and in the patients who had poorly differentiated squamous cell carcinoma or the carcinoma in advanced stage. Mean serum calcium level was higher in more symptomatic patients, and in the patients with worse performance scale or larger tumor mass. The prognosis of hypercalcemic patients with lung cancer was extremely poor.

호흡곤란을 호소하는 환자에서 호흡곤란 지수와 6분걷기 검사의 임상적 유용성에 대한 연구

이홍렬 ( Lee Hong Lyeol ),김세규 ( Kim Se Gyu ),장준 ( Jang Jun ),김성규 ( Kim Seong Gyu ),이원영 ( Lee Won Yeong ) 대한내과학회 1992 대한내과학회지 Vol.42 No.6

연구배경 : 호흡곤란은 임상적으로 중요한 증상이며 여러가지 요소들의 복합적인 상호작용에 의해 유발된다. 환자들이 호소하는 호흡곤란의 정도를 좀 더 정확히 평가하기 위해 정신물리학적 방법과 임상적 척도법이 사용되는데 전자는 기술이나 시간 등 몇가지 제한 요소 때문에 임상적으로 적용하기에는 어렵다. 임상적 척도법은 예민하고 생리학적 검사에 보완적인 정보를 제공할뿐 아니라 치료 효과의 평가에 유용한 것으로 보고되어왔다. 걷기 검사는 호흡기 질환 환자들의 일상생활에서의 생리적 운동 요구량을 잘 반영하며 재현성이 높고 약물 치료의 효과판정에 유용하다. 방법 : 호흡곤란을 주소로 내원한 39명의 환자들을 대상으로 치료 전과후에 각각 호흡곤란 지수의 측정, 6분 걷기 검사와 폐기능검사, 동맥혈 가스검사를 시행하고 치료전과 후의 값을 비교함으로써 호흡곤란 지수와 6분 걷기 검사가 임상적으로 유용한지 여부와 각 검사간의 상관관계에 대하여 연구하였다. 결과 : 전체 환자군에서 치료전에 비해 치료후에 PaC0_(2)외의 모든 검사치가 유의하게 호전되었고, 치료 전에서 MBS, BDI, 걷기 검사는 FEV_(1)과 유의한 상관관계를 보였으며. 치료후에서 MBS, 걷기 검사는 역시 FEV_(1),과 유의한 상관관계를 보였다. 만성 폐쇄성 폐질환 환자군에서는 치료전에 비해 치료후에 MBS, BDl, 걷기 검사값과 FVC값이 유의하게 호전되었고, 치료전에서 걷기검사는 FEV_(1), FVC, PaO_(2)와 유의한 상관관계를 보였다. 치료후에서 BDI는 PaO_(2), PaCO_(2)와, 그리고 걷기 검사는 FEV_(1), FVC, PaO_(2), PaCO_(2)와 유의하게 상관관계가 있었다. 기관지 천식 환자군의 경우 치료전에 비해 치료후에 FEF_(25~75%)와 PaC0_(2)를 제외하고 모든검사치가 유의한 호전을 보였다. 걷기검사와 FEF_(25~75%)는 치료 전후와 변화치 모두에서 유의한 상관관계를 보였으며, 치료후에서 MBS, BDI는 FEV_(1)와 유의한 상관관계를 보였다. MBS와 BDI간에는 치료 전과 후에서, 그리고 BDI와 걷기 검사간에는 치료후에 유의하게 상관관계가 있었다. 결론 : 호흡곤란 지수와 걷기 검사는 호흡기 질환 환자에서 치료효과의 평가에 유용한 것으로 생각되었으며 특히 만성 폐쇄성 폐질환 환자에서는 가장 예민하여 폐기능검사에 보완적인 수단으로 유용성이 있다고 생가되었다. 그리고 호흡곤란 지수, 특히 MBS는 전체 환자의치료 전과 후에서 FEV_(1)(% predicted)과 유의한 상관관계를 보였으며 특히 기관지 천식 환자군의 경우 치료전후의 변화치에서도 FEF_(25~75%)와 유의한 상관관계를 보였다. 걷기 검사는 만성 폐쇄성 폐질환 환자 군에서는 치료 전과후의 FEV_(1), FVC, PaO_(2)와, 기관지 천식 환자 군에서는 역시 치료전후의 변화치에서도 FEF_(25~75%)와 유의한 상관관계를 보였다. Backgrounds: Dyspnea, or pathologic breathlessness is frequently the patient s major complaint. As a symptom, it probably depends on a complex interplay of pathophysiologic, psychologic, experiential and other factors. Both psychophysical methods and clinical scales have been used to assess breathlessness. Several factors including technical aspects and time-requirement, limit the clinical application of evaluation in patients by psychophysical methods. Clinical scales can give sensitive and complementary information on physiologic measurements and they have proved very useful in testing the efficacy of a variety of physiologic and pharmacologic treatments for patients with chronic lung diseases. The walking test can measme a patient sability to undertake the physiologically demanding activities of day-to-day life, and it has proved to be highly reproducible and very useful to evaluate the efficacy of pharmacologic treatment. Methods: We measured dyspnea indices (modified Borg scale dyspnea index, baseline dyspnea index) and the distance patients could walk in 6 minutes in 39 patients who visited our hospital because of dyspnea before and after treatment. Pulmonary function test and arterial blood gas studies were done in the Same manner. Through the above method, we examined the clinical usefulness of the dyspnea index, the walking test, and the correlation between each test. Results: In all patients, all test values following teatment improved significantly except PaCO₂. The pretreatment values of MBS, BDI, the walking test and the posttreatment values of MBS and the walking test showed significant correlations with values of FEVI. In patients with COPD, the values of MBD, BDI, the walking test and FVC improved significantly. The pretreatment values of the walking test had significact correlation with those of FEV1, FVC and PaO₂. In the posttreatment values of BDI with those of Pa02, PaCO₂, there was a significant correlation and the result of the walking test was similar with FEV₁, FVC, PaO₂, PaCO₂. In patients with bronchial asthma, all test values except FEF_(25~75%) PaCO₂ showed significant improvement. The values of the walking test and FEF_(25-75%) showed a significant correlation in the preteatment, posttreatment and changed values between pretreatment and posttreatment values. The posttreatmet values of MBS and BDI correlated significantly with that of FEV₁. We could find a significant correlation between MBS and BDI in pretreatment and posttreatment values, between BDI and the walking test in posttreatment values. Conclusion: Dyspnea index and the walking test were proven useful for evaluation of treatment efficacy, and especially in patients with COPD, they were the most sensitive. They were valuable as supplementary to physiologic tests. Significant correlations were observed among dyspnea indices, especially MBS and FEV₁ in all patients. The walking test had significant correlations with FEV₁, FVC, PaO₂ in patients with COPD ariu with FEF(25~75%) in patients with bronchial asthma.

비소세포폐암에서 p53 종양억제 유전자와 K - ras 유전자의 돌연변이가 임상상에 미치는 영향

이홍렬(Hong Lyeol Lee),류정선(Jeong Seon Ryu),김주항(Joo Hang Kim),김성규(Sung Kyu Kim),이원영(Won Young Lee),이이형(Yi Hyung Lee) 대한내과학회 1998 대한내과학회지 Vol.55 No.5

N/A Objective: A multistep process of gene alterations is required for tumor formation, p53 gene mutation is the most frequent and K-ras gene mutation places second in the gene abnormalities of non-small cell lung cancer (NSCLC). The effect by the mutations of the p53 and ras genes on clinical manifestation is still highly controversial Little is known about the interaction between them in NSCLC. The present study was designed to investigate the effect by the mutations of the p53 tumor suppressor gene and K-ras oncogene on clinical manifestation, and the interaction between the mutations of two genes in the Korean NSCIC. Methods: Fifty-eight patients were enrolled in this study who had been diagnosed as having NSCLC from stage I to stage Ⅲ. They all had been alive for more than one month without any complication after curative resection. The paraffin-embedded lung tissues after resection were used to investigate the p53 expression by immunohistochemical staining, the mutations of the p53 and K-ras genes by polymerase chain reactionsingle strand conformation polymorphism(PCR-SSCP) and nucleotide sequencing. Results: p53 protein was overexpressed in 25.9% by immunohistochemical staining. Overexpression was significantly more frequent in epidermoid carcinoma(p=0.01634). But there was no significant difference between the overexpression group and the negative expression group according to stage and survival. By PCR-SSCP analysis, the mobility shift of the p53 gene was found in 29.1%. There was no significant difference between the groups with and without mobility shift according to cell type, stage and survival. By nucleotide sequencing, p53 gene mutation was 37.9%. The locations of mutation were dispersed among numerous codons and the modes of mutation were also diverse. There was also no significant difference between the groups with and without mutation according to cell type, stage and survival. K-ras gene mutation was 24.1% and only in codon 12 by nucleotide sequencing. Although there was no significant difference between the groups with and without mutation according to cell type or stage, K-ras gene mutation carried a significantly worse prognosis in NSCLC (overall survival p=0.0391, disease-free survival p=0.0318). When the patients were divided into 4 groups according to p53 gene mutation and K-ras gene mutation. there was also no significant difference among any group according to cell type or stage. The prognosis became worse if K-ras gene mutation accompanied(overall survival p=0.0021, disease-free survival p=0.0166). Only the stage(p=0.0313) and K-ras gene mutation(p=0.0457) were significant prognostic factors by Cox regression test. An analysis in stage III showed the significantly shorter survival period in the patients with K-ras gene mutation. K-ras gene mutation, therefore, was confirmed as the independently significant prognostic factor separately from stage. Conclusion: p53 gene mutation had no clinical or prognostic significance because of scattered locations and diverse modes of mutation in contrast to K-ras gene mutation, which had a significantly negative effect on the prognosis of NSCLC. p53 and K-ras gene mutations were apparently independent genetic alterations which played different roles in the clinical manifestation and prognosis of NSCLC.