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기관내 관 제거 후 발생한 급성 호흡부전에서 비침습적 양압 환기법의 유용성
나주옥 ( Joo Ock Na ),임채만 ( Chae Man Lim ),심태선 ( Tae Sun Shim ),박주헌 ( Joo Hun Park ),이기만 ( Ki Man Lee ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ),고윤석 ( Youn Suck 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.3
나주옥 ( Joo Ock Na ),서기현 ( Ki Hyun Seo ),박지영 ( Ji Young Park ),김정훈 ( Jung Hoon Kim ),김태훈 ( Tae Hoon Kim ),최재성 ( Jae Sung Choi ),김용훈 ( Yong Hoon Kim ) 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.2
Epithelioid hemangioendothelioma (EH) is a rare borderline malignant tumor which originating from vascular endothelial cells and occurs in many organs such as soft tissues, lung, liver and bone. But, pulmonary EH which simultaneously involves pleura and l
한국인에서 만성폐쇄성폐질환과 인체 폐 표면 활성제 단백-A 유전자 대립형질의 상관관계
나주옥 ( Joo Ock Na ),오명호 ( Myung Ho Oh ),최재성 ( Jae Sung Choi ),서기현 ( Ki Hyun Seo ),김용훈 ( Yong Hoon Kim ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.60 No.6
연구배경: 만성 폐쇄성폐 질환(이하 COPD)은 기도의 만성적인 염증이 특징인 질환이다. COPD의 발생에는 흡연 외에도 환경적, 유전적인 인자가 복합적으로 작용 한다. 폐 표면 활성제 단백-A(이하 SP-A)는 급성기 반응물질(acute phase reactant molecule)과 유사한 구조 및 기능을 가진 것으로 연구되어져 폐의 숙주방어와 염증반응에 중요하게 관여하는 것으로 알려졌다. 이에 저자들은 폐에서 염증 반응 및 면역에 관여하는 SP-A와 COPD군과의 유전자 대립형질을 비교분석하여 SP-A가 COPD의 병인에 관여하는 지를 밝히고자 본 연구를 시행하였다. 방법: 2004년 10월부터 2004년 12월까지 순천향대학교 천안병원 호흡기 내과에서 COPD로 진단되어 치료 받고 있는 환자 19명과, 순천향대학교 천안병원 신생아실에 입원한 정상 신생아 20명을 대조군으로 하여 PCR-cRFLP 방법을 사용하여 아미노산 염기 서열의 차이에 의해 SP-A의 유전자형을 연구 하였다. 결과: 1) COPD군의 SP-A1 유전자 대립형질은 대조군에 비해 6A2, 와 6A(18)이 통계적으로 유의하게 높은 빈도를 보였고, 6A3, 6A4는 낮은 빈도를 보였다. 2) COPD군의 SA-A2 유전자 대립형질 중 1A0는 대조군에 비해 통계적으로 낮은 빈도를 보였고, 1A2는 대조군에 비해 유의하게 높은 빈도를 보였다. 3) SP-A1의 50번째 nucleotide가 GG인 경우 COPD군에서 통계적으로 의미 있게 높았고, SP-A2의 9번째 nucleotide가 CC인 경우 COPD군에서 통계적으로 의미 있게 높았다. 결론: 우리나라에서는 SP-A의 특정 대립형질(inducer : 6A2, 6A(18), 1A2 & protector : 6A3, 6A4, 1A0)에 차이를 보이는 경우 COPD가 발생될 가능성이 높은 것을 알 수 있었고, 특히 SP-A1의 50번째 염기서열이 GG인 경우와, SP-A2의 9번째 염기서열이 CC인 경우에 COPD 발생 가능성이 높을 것으로 예측된다. Backgrounds: This study investigated whether or not a polymorphism in the gene encoding the surfactant protein A(SP-A) has any bearing on the individual susceptibility to the development of chronic obstructive pulmonary disease(COPD) in a genetically homogenous Korean population. Methods: The genotypes of 19 COPD patients and 20 healthy neonates as controls were tested using a polymerase chain reaction followed by restriction fragment length polymorphism analysis for the SP-A gene. Results: The specific frequencies of the 6A2 and 6A18 alleles of SP-A1 and the 1A2 allele of SP-A2 were much higher in the COPD group than control group (p<0.05). However, the frequencies of the 6A3 and 6A4 alleles of SP-A1 and the 1A0 allele of SP-A2 in the COPD group were significantly lower than the control group. In the COPD group, the frequencies of the +50 locus genotypes GG of SP-A1 and the +9 locus genotypes CC of SP-A2 were 85.0% and 60.6%, respectively, and 19.7% and 24.8% in the control group, respectively. The frequencies of the polymorphic genotypes or alleles showed a statistically significant difference between the COPD group and the control group (P<0.05). Conclusion: A genetic polymorphism in SP-A is associated with the development of COPD in the Korean population. (Tuberc Respir Dis 2006; 60: 638-644)
나주옥(Joo Ock Na),김순종(Soon Jong Kim),심태선(Tae Sun Shim),임채만(Chae Man Lim),이상도(Sang Do Lee),김우성(Woo Sung Kim),김동순(Dong Soon Kim),김원동(Won Dong Kim),고윤석(Youn Suck Koh) 대한내과학회 2002 대한내과학회지 Vol.62 No.3
N/A Background: Diffuse alveolar hemorrhage (DAH) is an uncommon pulmonary disease. It could be occurred by diver se causes with the different response to the treatment. However, the clinical features of DAH have not been well known in Korea. Methods: Twenty cases identified as DAH between March of 1990 and July of 2000 at a university affiliated hospital were retrospectively reviewed. Results: The median age was 45yr (range: 18 ~73yr) with 11 females. Diagnosis was made by clinical and radiologic findings including hemoptysis, newly developed anemia, and diffuse bilateral lung opacities with the continuous bloody lavage fluid or bloody bronchial aspirate on bronchoscopy. The mean APACHE III score was 50.8 (±26.7) points. Hemoptysis prior to admission was observed in 8 (40%) patients. Diffuse crackles were heard on the bilateral lung fields in 18 cases. On chest radiographs, diffuse ground glass appearance and/or confluent air space consolidation with ill defined irregular margin were mainly observed. In patients with DAH the hemoglobin level fell a mean of 2.0 (±0.8) g/dL. Fourteen (70%) patient s received mechanical ventilation due to the respiratory failure. Six patients (30%) were dead during admission. Among these patients, 4 patients were dead due to refractory respiratory failure with continuous DAH. The bleeding tendency such as disseminated intravascular coagulation or low platelet count was higher in dead patient s than the survivors (p =0.018). The survivor s of DAH with noninfectious causes showed better responses to immunosuppressive drugs with/without plasmapheresis compared to nonsurvivors (p =0.003). Conclusion: DAH was pr one to develop acute respiratory failure and needed mechanical ventilation frequently. However, DAH of non-infectious causes showing a good response to the immunosuppresive therapy would have a better prognosis. In addition, DAH would have a worse prognosis in cases of combined bleeding tendency. (Korean J Med 62:258-267, 2002)
흉막과 간을 동시에 침범한 폐의 유상피 혈관내피종 1예
나주옥,서기현,박지영,김정훈,김태훈,최재성,김용훈,Na, Joo Ock,Seo, Ki Hyun,Park, Ji Young,Kim, Jung Hoon,Kim, Tae Hoon,Choi, Jae Sung,Kim, Yong Hoon 대한결핵및호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.2
폐의 유상피 혈관 내피종이 진단 당시 흉막과 간을 동시에 침범한 경우는 드물다. 저자 등은 폐에 결절이 있고 동측에 다량의 흉막 삼출액이 동반되어 있으면서 간에 다발성 결절을 보인 26세의 젊은 여자환자에서 개흉 폐생검으로 진단된 유상피 혈관내피종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Epithelioid hemangioendothelioma (EH) is a rare borderline malignant tumor which originating from vascular endothelial cells and occurs in many organs such as soft tissues, lung, liver and bone. But, pulmonary EH which simultaneously involves pleura and liver is very rare. In the present report, we describe an uncommon case of EH involving the lung, pleura and liver in a 26-year-old woman. Chest CT showed single nodule in right upper lobe with large amount of pleural effusion at ipsilateral side and abdominal CT multiple round low densities in liver. The EH was confirmed by microscopic analysis and immunohistochemical staining of CD34+ from open lung biopsy specimen.
특발성 폐동맥고혈압과 만성혈전색전성 폐고혈압의 임상상 비교
김현국 ( Hyun Kuk Kim ),나주옥 ( Joo Ock Na ),안종준 ( Jong Joon Ahn ),박용범 ( Yong Bum Park ),임재민 ( Jae Min Lim ),홍상범 ( Sang Bum Hong ),오연목 ( Yeon Mok Oh ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),고윤석 ( Youn S 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.59 No.2
정영규 ( Yeong Gyu Jeong ),이호성 ( Ho Sung Lee ),최재성 ( Jae Sung Choi ),나주옥 ( Joo Ock Na ),서기현 ( Ki Hyun Seo ),김용훈 ( Yong Hoon Kim ),이승진 ( Seung Jin Lee ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.6
We report the case of a 32-year-old woman presenting with intermittent chest pain resulted from a migratory acupuncture needle. The patient received acupuncture treatment approximately 3 years prior to this presentation, for the treatment of chronic left shoulder and lumbar pain after delivery. Chest radiography revealed a retained needle in the lingular segmental area. Video-assisted thoracoscopy was then used to remove the migratory acupuncture needle attached between the lingular segmental lobe and the pericardial fat. The patient recovered without complications and was discharged home.
스테로이드 치료로 호전을 보인 폐동맥 고혈압을 유발한 특발성 섬유화성 종격동염
정보용 ( Bo Yong Jung ),어성준 ( Sung Jun Eo ),박은서 ( Eun Seo Park ),김영통 ( Young Tong Kim ),최재성 ( Jae Sung Cho ),오미혜 ( Mi Hye Oh ),서기현 ( Gi Hyun Seo ),나주옥 ( Joo Ock Na ),이상도 ( Sang Do Lee ),어수택 ( Soo Taek Uh 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.1
Idiopathic fibrosing mediastinitis is, an uncommon cause of pulmonary hypertension this is characterized by excessive fibrosis of the mediastinum with an unknown etiology. Steroid therapy has been suggested for individuals with progressive symptoms, bu there is littlet data demonstrating the efficacy of such therapy are lacking. We present a case of pulmonary hypertension secondary to a compression of a main pulmonary artery by fibrosing mediastinitis which was confirmed by a biopsy with a thoracotomy. The chest CT scan and 2D echocardiography performed before and after a trial of steroid therapy demonstrated improvement after steroid therapy. (Tuberc Respir Dis 2006; 61: 74-79)