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내과계 중환자실에 입원한 객혈 환자들에 있어 APACHE 3 점수 체계의 예후적 가치에 관한 연구
양성연(Sung Yeun Yang),고윤석(Youn Suck Koh),임채만(Chae Man Lim),이무송(Moo Song Lee),유미란(Mi Ran Yoo),최강현(Gang Heun Choi),이상도(Sang Do Lee),김우성(Woo Sung Kim),김동순(Dong Soon Kim),김원동(Won Dong Kim) 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Background: Massive hemoptysis is one of the major medical emergency with high risk of mortality. Though the best predictor of mortality associated with hemoptysis appears to be the amount of bleeding within the first 24 hours, catastrophic hemorrhage could be occurred to the patients who were apparently in a stable condition with scanty hemoptysis at the time of admission. We evaluated APACHE III score system to find if it could be a prognostic index that can predict the mortality of the patients with hemoptysis. Methods : We identified all the patients who had admitted with hemoptysis in the Medical Intensive Care Unit of Asan Medical Center between May 25, 1989, and July 31, 1995. A retrospective analysis was done in 66 patients with hemoptysis on APA- CHE III score. Results: The overall mortality rate was 17.4% (12/69). In univariate analysis of possible prognostic factors, independent predictors of mortality were age(P=0.016), amount of hemoptysis(P=0.012), AaDO2 (P=0.017), requirement of transfusion(P=0.036), mechanical ventilatory care(P<0.05) and APACHE III score(P=0.02), In multivariate analysis with sex, age, amount of hemoptysis, AaDO2, requirement of transfusion and APACHE III score, APACHE III score was the only independent predictor of mortality(P=0.015, odd ratio=19.3, 95% confidence interval, 3.4 to 249.7) Conclusion: APACHE IU score may be a clinically significantly important independent predictor of outcome in the patients with hemoptysis. In addition, invasive procedure, such as bronchial artery embolizaticn or operation, could be considered in advance in the patients with more than 30 points of APACHE III.
호흡재활치료 전후 31P 자기공명분석법을 이용한 골격근대사의 변화에 관한 연구
조원경 ( Won Kyung Cho ),김동순 ( Dong Soon Kim ),최강현 ( Kang Hyeon Choe ),박영주 ( Young Joo Park ),임태환 ( Tae Hwan Lim ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.5
CPAP 및 SIMV Mode하에서 Pressure Support 사용이 호흡역학에 미치는 효과
임채만 ( Chae Man Lim ),장재원 ( Jae Won Jang ),최강현,이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ),박평환 ( Pyung Whan Park ),최종무 ( Jong Moo Choi ) 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.3
신형식,최기원,최강현,이상도,배장환,이기형 충북대학교 의과대학 충북대학교 의학연구소 1997 忠北醫大學術誌 Vol.7 No.2
우중엽 증후군은 우중엽 기관지 주변의 병변으로 우중엽의 허탈을 유발하는 질환 군이다. 본 연구에서는 1992년 8월부터 1997년 6월까지 충북대학교병원을 방문한 우중엽 증후군 환자를 대상으로 임상적인 고찰을 하였다. 우중엽 증후군 환자는 총 27명이었고, 남자 12명, 여자 15명이었으며 이들의 평균연령은 60세이었다. 주요 증상은 객담을 동반한 기침이었고, 호흡곤란 및 흉통 등의 증상이 있었다. 이학적 소견으로는 국소적 수포음이 가장 많았고 호흡음의 감소, 천명음 등이 있었다. 원인 질환은 기관지 결핵이 9예로 가장 많았고 폐암 7예, 폐렴 6예, 기관지확장증 및 원인 미상의 만성 염증이 각각 2예, 기관지결석 1예의 순이었다. 기관지경 검사상 우중엽기관지가 폐쇄된 경우가 11예로 가장 많았으나 좁아진 경우 5예, 좁아지거나 폐쇄되지 않은 경우도 7예가 있었다. 흥부 전산화단층촬영으로 악성과 양성 질환을 비교적 잘 감별할 수 있었다. Right middle lobe syndrome is a syndrome in which right middle lobe is collapsed due to any disease. Because the clinical features were rarely studied in Korea, we evaluated the clinical features of 27 patients with RML syndrome from August 1992 to June 1997. There were 12 male patients and 15 female patients, with mean age 60 years old. The most common symptom was productive cough and the most common physical finding was localized crackle. The underlying diseases were 9 cases of endobronchial tuberculosis, 7 cases of bronchogenic carcinoma, 6 cases of pneumonia, 2 cases of bronchiectasis, 2 cases of chronic inflammation of unknown etiology and 1 case of broncholithiasis. RML bronchi were obstructed in 11 cases, narrowed in 5 cases and patent in 7 cases on bronchoscopy. Chest CT scans relatively well discriminated between benign and malignant lesion.