http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
기도 흡인 위험도에 따른 성인의 기도 내 이물의 임상적 특징
김이형 ( Yee Hyung Kim ),최천웅 ( Cheon Woong Choi ),최혜숙 ( Hye Sook Choi ),박명재 ( Myung Jae Park ),강홍모 ( Hong Mo Kang ),유지홍 ( Jee Hong Yoo ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.5
연구배경: 국내에서 굴곡성 기관지경에 의해 기도 내 이물이 확인된 성인 환자에서 흡인의 위험도에 따른 임상적 특징 및 이물 제거 방법 및 결과에 대한 보고가 없어 본 연구를 계획하였다. 방법: 1994년 12월부터 2004년 12월까지 경희대학교 부속병원에서 굴곡성 기관지경을 시행하여 기도 내 이물이 확인되었던 29명의 성인 환자를 대상으로 면밀한 의무 기록을 바탕으로 후향적 분석을 시행하였다. 결과: 14명은 흡인의 위험인자가 없었던 반면 15명은 흡인의 위험도가 높은 중추신경계 질환을 가지고 있었다. 전체 환자 중, 7명(24.1%)은 흡인에 대한 과거력이 없었다. 22명의 환자가 호흡기 증상이 확인되었는데, 기침(62.0%), 호흡곤란(44.8%), 발열(20.7%), 천명(13.8%), 흉통(10.3%) 및 객혈(0.4%) 순이었다. 흡인의 위험인자가 없는 환자의 92.8%가 증상이 발생한 반면 흡인 위험도가 높은 환자에서는 60%에서만 증상이 발생하였다(p=0.005). 또한 진단이 되기까지 증상 발생 기간이 각각 4일과 2일로 흡인 위험도가 높은 환자들에서 더 길었고(p=0.007), 3일 이내의 급성 호흡기 증상이 발생한 경우가 더 적었다(p=0.048). 6명(20.9%)의 환자가 단순 흉부 방사선에서 이상 소견이 없었던 반면 23명에서는 이물의 음영(11명), 폐렴(8명), air trapping(5명) 및 무기폐(3명) 등의 소견이 관찰되었다. 흡인의 위험도에 따른 기도 내 이물에 의한 방사선학적 특징에는 차이가 없었다. 흡인 위치로는 우측 기관지가 16예로 가장 많은 빈도를 보였고 우측 하엽 기관지가 가장 흔한 위치였다. 흡인 이물의 종류로는 치아가 11예로 가장 많은 빈도를 보였다. 흡인의 위험도가 높은 환자들에서 의학적 처기가 기도 내 이물 흡인이 발생하는 가장 흔한 경우였다. 모든 대상 환자의 기도 내 이물은 큰 부작용 없이 성공적으로 모두 제거되었으며 alligator jaw biopsy forceps이 이물 제거를 위해 가장 많이 사용되었다. 결론: 본 연구는 흡인의 위험도가 높은 환자에서는 이물 흡인의 과거력이 명확하지 않고 비전형적인 호흡기 증상을 보이는 경우가 많아 진단이 지연되거나 간과될 가능성이 높고 특히 의학적 처치 시 가장 많이 발생한다는 것을 보여주었다. 따라서 흡인의 위험성이 높은 환자에서 이물 흡인에 대한 적극적인 검사와 주의가 필요할 것으로 사료된다. Background: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. Methods: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. Results: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n=11). Alligator jaw biopsy forceps (n=23) was the most commonly used equipment. All of the FBs were removed without significant complications. Conclusion: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases. (Tuberc Respir Dis 2008;64:356-361)
증례 : 호흡기 ; 원발 병변의 재발 없이 흉막전이를 보인 자궁경부암 1예
김연주 ( Yeon Ju Kim ),박소영 ( So Young Park ),김이형 ( Yee Hyung Kim ),최천웅 ( Cheon Woong Choi ),유지홍 ( Jee Hong Yoo ),강홍모 ( Hong Mo Kang ),박명재 ( Myung Jae Park ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
C형 간염 보균자, 3년 전 자궁경부암으로 광범위한 자궁 절제술과 함께 동시 항암요법과 방사선 치료 받았고, 1년 전에는 좌측 소뇌-교각 청신경종양으로 종양 제거술 받은 환자로 점차 진행하는 호흡곤란을 주소로 내원하였다. 흉부단순촬영 및 흉부 컴퓨터단층촬영상 좌측 흉수를 동반한 흉막종괴 소견 보였고, 이에 대해 흉강경을 이용한 조직 검사상전이성 선암종으로 진단되어 cisplatin과 topotecan 병합 항암요법 시행 후 퇴원하였으며, 현재 흉수 소견 및 전이 소견을 관찰되지 않는 상태로 외래 추적관찰 중인 환자로 드물게 원발병소의 전이 없이 흉막전이만 보인 자궁경부암 환자를 경험하였기에 증례를 보고하는 바이다. It is very rare for an exocervical adenocarcinoma to metastasize to the lung parenchyma and pleura. A 54-year-old woman was admitted with dyspnea and left pleural effusion on chest X-ray. She had a history of exocervical adenocarcinoma 3 years previously and was treated with hysterectomy, chemotherapy, and radiation therapy. Last year, she was diagnosed with a left vestibular schwannoma and underwent subtotal mass removal surgery. After admission, metastatic adenocarcinoma of the pleura was diagnosed by video-assisted thoracic surgery biopsy. We herein report the rare case of exocervical adenocarcinoma that presented as a metastatic lesion to the pleura 3 years after the initial diagnosis. (Korean J Med 2011;80:S199-S203)
전립선 암에서 Bicalutamide 사용으로 생긴 간질성 폐질환
김양균 ( Yang Kyun Kim ),김이형 ( Yee Hyung Kim ),이재진 ( Jae Jin Lee ),최천웅 ( Cheon Woong Choi ),유지홍 ( Jee Hong Yoo ),박명재 ( Myung Jae Park ),강홍모 ( Hong Mo Kang ) 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.4
Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/ day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.
급성 천식 발작의 합병증으로 발생한 자발성 종격동기종과 피하기종
손정일 ( Jung Il Son ),김현수 ( Hyun Soo Kim ),최재호 ( Jae Ho Choi ),이은정 ( Eun Jung Lee ),최천웅 ( Cheon Woong Choi ),김이형 ( Yee Hyung Kim ),유지홍 ( Jee Hong Yoo ),장원석 ( Won Seok Jang ),백승숙 ( Seung Sook Paik ),박명재 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.4
Background: Spontanous pneumomediastinum is an uncommon disease that is defined as the nontraumatic presence of free air in the mediastinum without any apparent underlying disease. Asthma is one of the most common health problems, and spontanous pneumomediastinum occurs as a rare complication of acute exacerbation of asthma. Case History: A 29-year-old man with asthma was admitted to the hospital with acute exacerbation of asthma. His respiratory rate was 14 min, and arterial oxgen saturation was 90% at room air. Chest X-ray shows pneumomediastinum and subcutaneous emphysema. Results: He was treated conservatively with oxygen and intravenous steroid therapy, and his clinical conditions improved. Subcutaneous emphysema and pneumomediastinum disappeared during the follow-up period. Conclusion: Spontaneous pneumomediastinum complicated by asthma exacerbation is usually self-limiting and well controlled with conservative management, but this condition can be potentially life threatening. (Korean J Asthma Allergy Clin Immunol 2011;31:307-310)
Henoch-Schonlein 자반증 임상양상으로 나타나 진단이 늦어졌던 웨게너 육아종증
송세빈 ( Se Bin Song ),최혜숙 ( Hye Sook Choi ),김이형 ( Yee Hyung Kim ),최천웅 ( Cheon Woong Choi ),박명재 ( Myung Jae Park ),유지홍 ( Jee Hong Yoo ),강홍모 ( Hong Mo Kang ),김윤화 ( Yoon Hwa Kim ),박주철 ( Joo Cheol Park ) 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.6
Wegener`s granulomatosis is a systemic vasculitis of the medium and small arteries, as well as of the venules, arterioles, and occasionally large arteries, and primarily involves the upper and lower respiratory tracts and the kidneys. Renal symptoms of Wegener`s granulomatosis are indistinguishable from those of vasculitis such as Henoch-Schonlein purpura and microscopic polyangiitis. This case, though initially diagnosed as Henoch-Schonlein purpura, was confirmed as Wegener`s granulomatosis from a lung biopsy fifteen years after the initial diagnosis. We report this case with a review of the literature. (Tuberc Respir Dis 2007;63:531-536)
조병현 ( Byung Hyun Cho ),최혜숙 ( Hye Sook Choi ),조창현 ( Chang Hyun Cho ),김이형 ( Yee Hyung Kim ),최천웅 ( Cheon Woong Choi ),박명재 ( Myung Jae Park ),유지홍 ( Jee Hong Yoo ),강홍모 ( Hong Mo Kang ) 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.6
Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia. Mycoplasma pneumonia causes upper and lower respiratory tract symptoms in all age groups, with the highest attack rates in subjects 5 to 20 years old. In patients with mycoplasma pneumonia, the most common radiographic findings may be reticulonodular or interstitial infiltration, which have a predilection for the lower lobes. Findings that show lung collapse on a chest X-ray are very rare. We report a case of mycoplasma pneumonia that showed right upper lobe collapse. (Tuberc Respir Dis 2007;63:511-514)
Man Pyo Chung, M.D., Ph.D.,Park Jong Sun,Kim Song Yee,유홍석,Jin Woo Song,정성환,Lee Jae Ha,이홍렬,Choi Sun Mi,김영환,Yonghyun Kim,최혜숙,Lee Jongmin,어수택,Kim Tae-Hyung,Kim Sang-Heon,Lee Won-Yeon,김이형,Lee Hyun Kyung 대한결핵및호흡기학회 2022 Tuberculosis and Respiratory Diseases Vol.85 No.2
Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients.Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015.Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-agephysiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.
이치훈 ( Chi Hoon Lee ),강성욱 ( Sung Wook Kang ),김동희 ( Dong Hee Kim ),민준기 ( Joon Ki Min ),김이형 ( Yee Hyung Kim ),최천웅 ( Cheon Woong Cho ),유지홍 ( Jee-hong Yoo ) 대한내과학회 2013 대한내과학회지 Vol.85 No.2
랑게르한스 세포 조직구증은 드문 조직구 질환의 하나로서 랑게르한스 세포가 증식하여 뼈를 비롯한 여러 장기를 침범하는 질환이다. 성인에서 폐와 함께 척추를 침범한 경우는 드물게 보고되고 있다. 저자들은 흡연력이 있는 젊은 남성에서 폐 병변은 금연에 의해 호전되었지만 척추 병변은 금연에도 불구하고 악화되어 심한 통증을 유발하고 척추 안정성에 문제를 보여 이를 수술적으로 치료한 1예를 경험하였기에 보고하는 바이다. Langerhans cell histiocytosis (LCH) is a proliferative disease that shares phenotypic characteristics with Langerhans cells (LCs) and involves multiple organs. Here, we report a case of LCH in a 36-year-old male simultaneously involving the lungs and thoracic spine. Chest computed tomography (CT) showed multifocal thin-walled cysts and ill-defined nodular opacities primarily in the bilateral upper and middle lung lobes that fluctuated with smoking. Despite improvement of pulmonary lesions after smoking cessation, osteolytic lesion of thoracic vertebra was aggravated. Symptoms were not improved after nerve block, suggesting vertebral instability that necessitated surgical mass removal and posterior fusion. Microscopically diffuse proliferation of immature, rounded LCs and inflammatory cell infiltration was noted. Although pulmonary LCH in an adult is a benign disease that is usually resolved spontaneously after smoking cessation, surgical treatment should be considered in a case of spinal LCH. (Korean J Med 2013;85:199-204)
병합치료 후 소실된 비소세포폐암 Gemcitabine 병발 신증후군
이은정 ( Eun Jung Lee ),이재진 ( Jae Jin Lee ),문주영 ( Ju Young Moon ),유지홍 ( Jee Hong Yoo ),최천웅 ( Cheon Woong Choi ),김이형 ( Yee Hyung Kim ),김교영 ( Gou Young Kim ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5
Nephrotic syndrome has been reported to accompany a malignancy. Since the first case of the nephrotic syndrome associated with extra-renal malignancy was reported in 1922, only a few cases of nephrotic syndrome accompanying other malignancies have been reported. Previous reports on such cases indicated a pattern of improvement in nephropathy as malignancy improved. But the cases of resolved nephropathy with aggravated cancer have scarcely been documented. Here we report a case of a 69 year-old male with nephrotic syndrome accompanying non-small cell lung cancer, whose proteinuria was normalized after chemotherapy while his cancer was aggravated.