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미만성 침윤성 페질환을 보이는 환자에서 방사선투시유도 절단침 페생검의 유효성
최수전 ( Soo Jeon Choi ),신은아 ( Eun Ah Shin ),김정숙 ( Joung Sook Kim ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.1
Background: Open lung biopsy is used for diagnosis of diffuse infiltrative lung diseases (DILD), but it is invasive and relatively expensive procedure. Fluoroscopy- guided cutting needle lung biopsy (FCNLB) has merits of avoidance of admission and rapid diagnosis. But diagnostic accuracy and safety were not well known in the diagnosis of DILD. Methods: We included 52 patients (37 men, 15 women) having DILD on HRCT with dyspnea, except the patients who could be confidently diagnosed with clinical and HRCT findings. FCNLB was performed using 16G Ace cut needle (length 1.5 cm, diameter 2 mm) at the area of most active lesion on HRCT. Final diagnoses were made by the consensus. Results: The mean interval between the HRCT and FCNLB was 4.5 days. Most cases were performed one biopsy during 5∼10 minutes. Specific diagnosis was obtained in 43 of 52 biopsies (83%). The most common diagnosis was nonspecific interstitial pneumonia (11 cases) and followed by cryptogenic organizing pneumonia (7 cases), diffuse alveolar hemorrhage and usual interstitial pneumonia (5 cases in each), hypersensitivity pneumonitis (3 cases), tuberculosis and drug induced interstitial pneumonitis (2 cases in each), the others are in one respectively. Mild complication was developed in 9 patients (8 pneumothorax, 1 hemoptysis). Most of complications were regressed without treatment except one case with chest tube insertion for pneumothorax. Conclusion: Fluoroscopy-guided 16 G cutting needle lung biopsy was an useful method for the diagnosis of DILD.
특집 - 폐쇄성 수면 무호흡증 : 폐쇄성 수면 무호흡의 합병증
최수전 ( Soo Jeon Choi ) 대한내과학회 2015 대한내과학회지 Vol.89 No.1
While obstructive sleep apnea is a well-known sleep disorder, undiagnosed and untreated patients are an enormous burden in Korea. An episode of obstructive sleep apnea can induce dramatic changes in hemodynamics, leading to desaturation/reperfusion injury. Many complications follow episodes of obstructive sleep apnea and result in cardiovascular and other diseases, such as hypertension, heart failure, stroke, coronary artery disease, arrhythmias, pulmonary hypertension, diabetes mellitus, impotence, and even cancer mortality. Consequently, the role of physicians in detecting, treating, and educating patients about obstructive sleep apnea becomes more important. (Korean J Med 2015;89:13-20)