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송은주 ( Eun Ju Song ),백대현 ( Dae Hyun Baek ),정준영 ( Jun Young Jung ),이상렬 ( Sang Ryul Lee ),이명하 ( Myong Ha Lee ),이성혁 ( Sung Hyuk Lee ),이재형 ( Jae Hyung Lee ),이기덕 ( Ki Deok Lee ),이병훈 ( Byoung Hoon Lee ),김상훈 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.6
연구배경: 결핵환자에서 항결핵제 치료 중 초기에 병변의 호전 이후 방사선학적, 임상적으로 이전의 병변이 악화 되거나 새로운 병변이 발생하는 경우를 역설적 반응이라 정의한다. 결핵흉막염에서의 역설적 반응 발생과 이와 관련된 인자에 대해서 알려진 바는 많지 않다. 방 법: 2004년 1월부터 2006년 12월까지 결핵흉막염으로 진단받고 4개월 이상 항결핵제를 복용한 환자를 대상으로 하였다. 항결핵제 투약 전과 투약 후 흉부 방사선의 변화를 연속적으로 살펴보고 치료시작 2주 후에 이전의 병변의 악화나 새로운 병변이 생긴 경우를 역설적 반응이 발생한 것으로 판정하였다. 역설적 반응군이 발생하였던 환자군과 발생하지 않았던 환자군 간의 임상적인 특성과 흉수, 혈액 검사를 비교하였다. 결 과: 대상환자 77명 중 역설적 반응을 보인 환자는 16명(21%)이었다. 역설적 반응을 보인 시기는 항결핵제 사용 후 평균 38.6일이었으며, 병변의 크기가 줄어드는데 걸리는 시간은 평균 32.1일이었다. 역설적 반응은 젊은환자에서(30.5세 vs 39.0세), 그리고 흉수의 백혈구 중 림프구의 백분율이 높았던 경우에서(82.1% vs 69.6%) 많이 발생하였다. 결 론: 결핵흉막염의 항결핵제 치료 중에 발생하는 역설적 반응은 드물지 않았으며 환자의 연령과 흉수의 백혈구 중 림프구의 백분율이 역설적 반응의 발생빈도와 관련이 있었다. Background: A paradoxical response is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion after initial improvement during theprocess of antituberculous treatment. The related factors for the development of a paradoxical response in patients with tuberculous pleurisy are not certain. Methods: We selected patients with tuberculous pleurisy who had been treated for more than 4 months. The changes onthe serial chest X-ray findings before and after treatment were reviewed. Paradoxical responses were regarded as any worsening or development of new lesion at least 2 weeks after the initiation of treatment. The baseline clinical characteristics and laboratory findings of the peripheral blood and pleural fluid were compared between the patients with a paradoxical response and the patients without a paradoxical response. Results: Paradoxical responses appeared in sixteen patients (21%) among the 77 patients.It took a mean of 38.6 days after the treatment and the time to resolve the paradoxical response was a mean of 32.1 days. For the patients with a paradoxical response, the median age was younger (30.5 years vs 39.0 years, respectively) and the lymphocytic percentage of white blood cells in the pleural fluid was higher (82.1% vs 69.6%, respectively) than for the patients without a paradoxical response. Conclusion: The development of a paradoxical response during the treatment of patients with tuberculous pleurisy was not rare and this was related with the age of the patients and the percentage of lymphocytic white blood cells in the pleural fluid.
이병훈 ( Byoung Hoon Lee ),이기덕 ( Ki Deok Lee ),김상훈 ( Sang Hoon Kim ),우정주 ( Jeong Joo Woo ) 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.62 No.3
Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia. (Tuberc Respir Dis 2007; 62: 227-231)
결핵후 폐손상에서 한국어판 St. George`s Respiratory Questionnaire를 이용한 건강 관련 삶의 질 평가
이병훈 ( Byoung Hoon Lee ),김영삼 ( Young Sam Kim ),이기덕 ( Ki Deok Lee ),이재형 ( Jae Hyung Lee ),김상훈 ( Sang Hoon Kim ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.3
연구배경: 결핵후 폐손상 환자에서 나타나는 다양한 폐기능 장애는 이들의 건강관련 삶의 질에 심각한 영향을 주고 있을 것으로 추정되나 이에 대한 연구는 거의 없다. 결핵후 폐손상 환자에서의 임상적 특징을 알아보고, 나아가 만성 호흡기 질환에서 건강관련 삶의 질을 평가하는 도구로 널리 사용되고 있는 세인트조지 호흡기설문(St. George`s Respiratory Questionnaire, SGRQ)의 한국어판이 결핵후 폐손상 환자에서도 유용하게 사용될 수 있을지를 평가하고자 하였다. 방법: 폐결핵의 치료가 종결된 지 6개월 이상 경과하였으며 흉부 단순 촬영상 한 측 폐 1/2 이상의 손상이 관찰되는 결핵후 폐손상 환자에서 SGRQ를 시행하고 폐활량검사, 운동부하 심폐기능검사, HRCT의 결과와 비교하여 연관성을 살펴보고 SGRQ의 결핵후 폐손상의 평가에 있어 신뢰도와 타당도를 검정하였다. 결과: 폐기능검사에서 혼합형 환기장애와 폐쇄성 환기장애는 각각 10명(45.0%), 9명(40.9%)에서 관찰되었다. 운동부하 심폐기능검사에서 평균 VO2max% predicted는 39.0±10.9% 평균 O2 pulse% predicted는 61.3±13.6%로 감소되어 있었다. 한국어판 SGRQ는 영향영역점수가 평균 27.8±18.5로 증상영역 평균 53.9±20.9 활동영역 평균 50.8±27.3에 비하여 점수가 낮았다(p<0.05, p<0.01). Cronbach`s alpha coefficient는 각각의 영역과 총 점수에서 모두 0.7 이상이었다. 총 점수는 FEV1% predicted(r=-0.46, p<0.05), 동맥혈산소포화도(r=-0.60, p<0.05), HRCT 비손상 기관지폐구역수(r=-0.52, p<0.05) 등과 관련이 있었다. 결론: 결핵후 폐손상환자 대부분에서 폐쇄성 환기장애가 동반되었다. 한국어판 SGRQ는 결핵후 폐손상 환자의 삶의 질을 평가하는데 적절한 타당도와 신뢰도를 보여주었다. Background: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. Methods: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George`s Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. Results: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean VO2max% predicted (39.0%±10.9%) and O2 pulse% predicted (61.3%±13.6%) were markedly decreased. In the SGRQ, the impact score (mean 27.8±18.5) was significantly lower than the symptom score (mean 53.9±20.9) or activity score (mean 50.8±27.3) (p<0.05, p<0.01). Cronbach`s alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with FEV1% predicted (r=-0.46, p<0.05) and SaO2 (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). Conclusion: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.
윤명환(Myung-Hwan Yoon),이기덕(Ki-Deok Lee),이정종(Jeong-Jong Lee) 한국자기학회 2021 韓國磁氣學會誌 Vol.31 No.3
The LSPM (line-start permanent magnet synchronous motor) is an alternative to increase the efficiency and power factor of induction motors. Magnetization of permanent magnet in LSPM is the most important issue for manufacturing process. The manufacturing process can be improved as the magnetization of the permanent magnet is conducted after the rotor assembly. Circuit of LSPM magnetization after the assembly is introduced and finite element analysis is conducted. Finally, magnetizing yoke is manufactured and the magnetization is conducted. Flux density in the permanent magnet of LSPM rotor is checked. The result is presented for the verification of the magnetizing analysis.