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전수연 ( Su Yeon Chon ),김유진 ( Yu Jin Kim ),경선영 ( Sun Young Kyung ),안창혁 ( Chang Hyeok An ),이상표 ( Sang Pyo Lee ),박정웅 ( Jeong Woong Park ),정성환 ( Sung Hwan Jeong ),조은경 ( Eun Kyung Cho ),성연미 ( Yon Mi Sung ),김 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.2
A 23-year old woman was admitted to our hospital with hemoptysis. The chest X-ray showed reticulonodular opacity and multiple cysts throughout the entire lung field. The chest CT scan revealed numerous bilateral cysts with various sizes, some of them with thickened walls. An open lung wedge resection was performed. The resected specimen showed scattered small nodules, 0.3 to 0.6 cm in size. Microscopically, each nodule was composed of atypical glands with an occasional papillary architecture spreading to the alveolar septa, which were morphologically consistent with a papillary adenocarcinoma with a bronchioloalveolar carcinoma growth pattern. Immunochemically, the tumor cells were negative for the S-100 protein. The patient was diagnosed with an adenocarcinoma of the lung. A variety of diseases can produce or mimic multiple, thin-walled cysts in the lung. Lung cancer with multiple cysts is quite rare. Nevertheless, adenocarcinoma should be a diagnostic consideration. We report a case of a multiple cystic adenocarcinoma of the lung.
전수연 ( Su Yeon Chon ),김유진 ( Yu Jin Kim ),경선영 ( Sun Young Kyung ),안창혁 ( Chang Hyeok An ),이상표 ( Sang Pyo Lee ),박정웅 ( Jeong Woong Park ),정성환 ( Sung Hwan Jeong ) 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.62 No.6
연구 목적 및 방법: 수술 후 폐 합병증은 심장 합병증보다 흔하고 술 후 입원기간 연장 및 사망률을 높이는 중요한 합병증이다. 최근 NSQIP에서 수술 후 중요한 폐 합병증인 폐렴과 호흡 부전의 위험 인자를 제시하였으나, 복잡하고 폐기능이나 동맥혈 가스 분석 같은 기본적인 검사 소견은 고려되지 않은 면이 있다. 또한 국내 연구에서는 수술 후 폐 합병증의 위험 인자가 명확치 않다. 이에 전향적 연구로 수술 후 폐 합병증의 위험 인자를 알아보고자 하였다. 가천의대 길병원에서 호흡기내과로 의뢰된 환자 199명을 대상으로 수술 후 폐 합병증(폐렴, 호흡 부전, 무기폐, 흉수)이 생긴 환자군과 그렇지 않은 군의 위험 인자를 비교하였다. 결과: 22명(11.1%)에서 수술 후 폐 합병증이 발생하였고, 흉수(13명), 호흡 부전(6명), 폐렴(4명), 무기폐(2명) 순이었다. 단변량 분석에서 폐 합병증의 유의한 위험 인자는 높은 cardiac risk index, 수술 전 후 nasogastric tube 사용, 흉부/상복부 수술, 3시간 이상의 마취 시간, 술 전 11.0 g/dL 이하의 헤모글로빈으로 나타났으며, 다변량 로지스틱 회귀 분석 상 독립적인 위험 인자는 응급 수술(OR 10.306, 95% CI= 1.508-70.438, p=0.017), 높은 심장 위험도(OR 16.454, 95% CI=2.720-99.521, p=0.002), 수술 종류(OR 3.814, 95% CI=1.016-14.313, p=0.047)로 나타났다. 결론: 수술 후 폐 합병증 발생의 위험 인자는 응급 수술, 높은 심장 위험도, 흉부/상복부 고위험 수술로 수술적 요인과 기저 심장 상태가 중요하며, 폐기능 검사나 흉부 방사선 이상 소견은 술 후 폐 합병증 발생에 영향을 미치지 않는 것으로 생각된다. 향후 대상군의 범위를 넓히고, 좀 더 많은 환자에서 수술 후 폐 합병증 발생의 위험 인자를 분석하는 것이 필요하리라 생각된다. Background: Postoperative pulmonary complications are important problems that prolong the length of the hospital stay and increase patient mortality. However, our knowledge of the postoperative factors that increase the risk of these complications is less than complete. Methods: We conducted a prospective study to determine the risk factors for postoperative pulmonary complications. A total of 199 patients were referred to the Pulmonology Department for preoperative pulmonary evaluation. We reviewed the perioperative variables according to the National Surgical Quality Improvement Program (NSQIP). Postoperatively, we collected data on the occurrence of postoperative pulmonary complications and we evaluated the relationship between the perioperative variables and outcomes. Results: Twenty two patients (11%) had pulmonary complications; 6 had respiratory failure, 4 had pneumonia, 13 had pleural effusion and, 2 had atelectasis. Five variables were statistically significantly associated with pulmonary complications on the bivariate analyses. Multiple logistic regression analyses revealed that three of these variables were independently associated with an increased risk of pulmonary complications; a high cardiac risk index (OR 16.5, p=0.002), emergency surgery (OR 10.3, p=0.017), and thoracic/abdominal surgery (OR 3.8, p=0.047). Conclusion: The risk factors for postoperative pulmonary complications are a high cardiac risk index, emergency surgery and thoracic/abdominal surgery. (Tuberc Respir Dis 2007; 62: 516-522)
태안 Hebei Spirit 유출 유류 제거작업 후 발생한 호흡부전
경선영 ( Sun Young Kyung ),전수연 ( Su Yeon Chon ),김유진 ( Yu Jin Kim ),이상표 ( Sang Pyo Lee ),박정웅 ( Jeong Woong Park ),정성환 ( Sung Hwan Jeong ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.3
On 7 December 2007, the Hebei Spirit ran aground near Taean and released approximately 10,900 tons of oil into the sea. Crude oil on the coastal areas and fumes in the air increased the number of health problems among the local population. We report a case of respiratory failure after the oil spill clean-up work. A 66-year-old female was admitted to hospital with cough, sputum, and dyspnea of 1-month duration after the oil spill clean-up. She was diagnosed with community-acquired pneumonia and treated with empirical antibiotics. However, she had progressive respiratory failure without identification of the pathogen. Respiratory failure due to chronic inhalation of hydrocarbons from the crude oil spill clean-up was suspected. After mechanical ventilation care, she recovered from respiratory failure and was discharged. We report a case of severe respiratory toxic effects. after an oil spill clean-up. We concluded that long-term hydrocarbon inhalation during the oil spill clean-up may have induced respiratory failure in this case.
폐 섬유모세포에서 황사의 미세먼지(Particulate Matter 10)가 활성산소족과 TGF-β, NF-κB, PDGF-α, Fibronectin의 생성에 미치는 영향
김아현 ( Ah Hyun Kim ),전수연 ( Su Yeon Chon ),윤진영 ( Jin Young Yoon ),김유진 ( Yu Jin Kim ),경선영 ( Sun Young Kyung ),이상표 ( Sang Pyo Lee ),박정웅 ( Jeong Woong Park ),정성환 ( Sung Hwan Jeong ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.6
Background: Dust clouds blown by the wind from the arid deserts of Mongolia and Northeast China are known as Asian dust storms. Ambient particulate matter with a diameter <10 μm (PM10) is associated with the exacerbation of respiratory diseases and increased mortality of heart and lung disease patients. The fibrotic effects of PM10 of Asian dust to pulmonary fibroblast cells are unknown. This study examined the production of reactive oxygen species (ROS), TGF-β, NF-κB, PDGF-α and Fibronectin in fibroblasts exposed to Asian dust particles. Methods: Air samples were collected using a high volume air sampler (Sibata model HV500F) with an air flow of 500 L/min for at least 6 hours. The MRC-5 cells were exposed to 0, 50 and 100 μg/mL of PM10 for 24 hours. ROS was detected by measuring the level of oxidized DCF using FACS. TGF-β, NF-κB, PDGF-α and fibronectin were detected by western blotting. Results: There was no increase in the ROS, TGF-β and PDGF-α levels in the MRC-5 cells exposed to PM10. The NF-κB level was higher in the MRC-5 cells exposed to 50 and 100 μg/mL of PM10 for 24 hours. The fibronectin level in the MRC-5 cells after 24 hours incubation with 50 μg/mL PM10 was significantly higher than the control group (PM10 50 μg/mL 113.27±8.65 of control, p=0.005). Conclusion: PM10 from Asian dust increases the activation of NF-κB and fibronectin expression in MRC-5 fibroblast cells.
경중 호산구증다증을 동반한 개회충 2기유충에 의한 안구내유충이행증
김정호 ( Jung Ho Kim ),전효근 ( Hyo Keun Jeon ),전수연 ( Su Yeon Chon ),임영희 ( Young Hee Lim ),이상표 ( Sang Pyo Lee ),정성환 ( Sung Hwan Jeong ),신경환 ( Kyung Hwan Shyn ),최동철 ( Dong Chull Choi ),강신영 ( Shin Young Kang 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.4
We report a case of intraocular toxocariasis in a 45-year-old man who presented with impaired visual acuity of the left eye. He denied a trauma history on his eyes. He had been entirely free of ophthalmic symptoms until hospitalization. Mild peripheral eosinophilia was present. Fundus photography revealed a round, yellow-white, and solid intraretinal granuloma of 1/2 disc in diameter at the posterior pole of the left fundus. Aqueous humor aspiration was perforemed. We have preformed ELISA using T. canis excretory-secretory antigen and found higher antibody titers in the aqueous humor and the serum. At 4 weeks after combined prednisolone and albcndazol therapy, the size of granuloma was decreased. The patient`s visual acuity of the left eye improved from 20/200 to 20/30. (Korean J Asthma Allergy Clin Immunol 2005;26:322-325)
체외수정 시술 후 프로게스테론 근육주사와 연관된 급성 호산구성 폐렴
박성근 ( Sung Keun Park ),최병호 ( Byoung Ho Choi ),전수연 ( Su Yeon Chon ),김유진 ( Yu Jin Kim ),경선영 ( Sun Young Kyung ),이상표 ( Sang Pyo Lee ),정성환 ( Sung Hwan Jeong ),박정웅 ( Jeong Woong Park ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.6
Acute eosinophilic pneumonia (AEP) is characterized by idiopathic acute febrile illness, diffuse pulmonary infiltration, severe hypoxemia, and pulmonary eosinophilia. We report a case of AEP associated with intramuscular administration of progesterone as luteal phase support after in vitro fertilization. A 33-year-old woman presented to our emergency room with tachypnea and hypoxemia, complaining of fever and cough for 4 days, and dyspnea for 2 days. The symptoms began 9 days after the first injection of progesterone. Chest radiograph showed bilateral infiltrates, located predominantly in the periphery of the lungs, with blunting of the costophrenic angle. Symptoms and chest radiograph dramatically improved after corticosteroid therapy and shifting the progesterone from an intramuscular form of administration to a vaginal form of administration.