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원저 : 내독소에 의한 돼지의 급성 폐손상에서 산소기의 역할에 관한 연구
김영환 ( Young Whan Kim ),유철규 ( Chul Gyu Yoo ),정기호 ( Ki Ho Jeong ),최형석 ( Hyung Seok Choi ),이혁표 ( Hyuk Pyo Lee ),한성구 ( Sung Koo Han ),심영수 ( Young Soo Shim ),김건열 ( Keun Youl Kim ),한용철 ( Yong Chol Han ) 대한결핵 및 호흡기학회 1991 Tuberculosis and Respiratory Diseases Vol.38 No.4
경피증 ( Scleroderma ) 의 폐침범에 관한 임상적 고찰
김영환(Young Whan Kim),한성구(Sung Koo Han),최성재(Sung Jai Choi),심영수(Young Soo Shim),김건열(Keon Youl Kim),한용철(Yong Chol Han) 대한내과학회 1987 대한내과학회지 Vol.34 No.1
N/A Pulmonary function tests and chest X-ray's were analyzed in 100 scleroderma patients who have been diagnosed in Seoul National University Hospital during recent 7 years to study on the pulmonary involvement of scleroderma. 1) Among 90 patients, 44% showed interstitial lung disease on chest X-ray's. Mild involvement was 31%, moderate 11.1% and severe 2.2% respectively. 2) 66.7% of patients showed FVC less than 80% of predicted value, but only 26.5% showed FBV1/FVC less than 80%, characterizing restricitive pulmonary function abnormality. 3) 79.4% of patients showed Diffusing Capacity less than 80% of predicted value. 4) Severity of chest X-ray abnormality showed correlation with disease duration, but FVC and Diffusing Capacity did not show statistically significant correlation with disease duration. 5) Chest X-ray abnormality and Diffusing Capacity were not statistically correlated. According to these results, the most sensitive test to find pulmonary involvement in scleroderma is Diffusing Capacity, and chest X-ray alone is not sufficient.
김호중(Ho Joong Kim),최형석(Hyung Suk Choi),심태선(Tae Sun Shim),이혁표(Hyeok Pyo Lee),김영환(Young Whan Kim),허대석(Dae Seog Heo),한성구(Sung Koo Han),심영수(Young Soo Shim),김노경(Noe Kyeong Kim),김건열(Keun Youl Kim),한용철(Yong C 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A Pulmonary toxicity is a potentially fatal complication of bleomycin, one of the well-known anti-cancer chemotherapeutics. The incidence of bleomyicn-induced pulmonary toxicity was reported as 2-40% and fatality, 1-2%. Bleomycin-induced pulmonary toxicity is sometimes progressive even after discontinuation of the drug, but there has been no specific treatment modalities other than prevention, Forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLco) have been proposed as parameters valuable in predicting subclinical bleomycin-induced pulmonary toxicity, but there are still conflicting results. To discover the predicting factors for bleomycin-induced pulmonary toxicity, 15 patients treated with 6 cycles of cyclophophamide, vinblastine, prednisolone, bleomycin, adriamycin and procarbazine (COPBLAM- III) for non-Hodgkin's lymphoma at Seoul National University Hospital between March 1989 and March 1990 were studied prospectively. Routine physical examination, complete blood count, chest X-ray and pulmonary function test including DLco were done at initial diagnosis, then every 2 cycles and at restaging, and 1 month after the last treatment. The results were as follows: 1) Carbon monoxide diffusing dapacity (DLco) decreased from the 6th cycle (cumulative dose was average 347 u) and persisited thereafter, but the decrement was not dose-dependent. 2) There were no interval changes in forced vital capacity (FVC), forced expiratory volume 1-second (FEV1), FEU1/FVC, mean forced expiratory flow during middle half of the FVC (MEF), and MEF/FVC. 3) Based on radiological critieria, bleomycin-induced pulmonary toxicity developed in 1 patient (6.7%). At this point, the cumulative dosage of bleomycin was 312 u and DLco decreased by 57%. 4) If the predictive critieria was determined as 55% decrement of DLco, the false positive rate was 66.7%. In this study, no parameters were found to predict bleomycin-induced pulmonary toxicity. In conclusion, DLco is not a universally sensitive predictor of bleomycin-induced pulmonary toxicity, but may be a preceding parameter. It is recommended that for all patients who are administered over 300 u of bleomycin, a periodic physical examination, DLco and chest X-ray should be done for early detection of bleomycin-induced pulmonary toxicity. .
김우성(Woo Sung Kim),정희순(Hee Soon Chung),김영환(Young Whan Kim),방영주(Yung Jue Bang),한성구(Sung Koo Han),심영수(Young Soo Shim),김노경(Noe Kyeong Kim),김건열(Keun Youl Kim),한용철(Yong Chul Han) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A To determine the role of bronchoscopy (FOB) in restaging of small cell lung cancer (SCLC) after at least 6 cycles of chemotherapy, we performed a prospective study from 1986 to 1988 in Seoul National University Hospital. Restaging was done 42 times in 38 patients with SCLC who showed no evidence of disease on chest X-ray. The results were as follows: 1) Of the 29 cases in whom FOB was done at the time of initial diagnosis, histologic or cytologic diagnosis of SCLC was made in 26cases(89.7%). 2) On restaging FOB, 18 cases showed a gross appearance suggestive of remnant tumor (mass or infiltration), of whom either bronchoscopic biopsy or cytology was positive in 8 cases (44.4%). Of the 24 cases without gross evidence of tumor, bronchoscopic biopsy or cytology at the original tumor site was positive in 2 cases(8.3%). 3) Retreatment was planned in 22 cases according to the results of restaging procedures, Of these 22 cases, 14 cases (67.6%) showed evidence of remnant tumor on restaging FOB, including 4cases in which remnant disease was detected only by FOB. In conclusion, FOB is mandatory in restaging of SCLC, and bronchoscopic biopsy and/or cytology should be done even if the gross appearance shows normal or only fibrotic changes. Also it is thought that bronchoscopic evaluation at the time of initial diagnosis is helpful for comparison on restaging.