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기관지 유암종에 대한 임상적 연구 - 후두 및 기관 유암종을 포함해서 -
이홍렬 ( Lee Hong Lyeol ),권선옥 ( Kwon Seon Og ),김세규 ( Kim Se Gyu ),김형중 ( Kim Hyeong Jung ),장준 ( Jang Jun ),안철민 ( An Cheol Min ),홍천수 ( Hong Cheon Su ),김성규 ( Kim Seong Gyu ),이원영 ( Lee Won Yeong ),신동환 ( Sin 대한내과학회 1993 대한내과학회지 Vol.44 No.5
Backgrounds: Bronchial carcinoids are low-grade malignant neuroendocrine tumors arising from the Kulchitsky cells of the respiratory epithelium and comprise 1% to 2% of all primary lung tumors. Clinical manifestations and course of bronchial carcinoids mainly depend on their location and histologic features. The central and typical carcinoids, respectively, are more common. Surgical resection is the choice of treatment and the prognosis is determined by the size, histologic features of the tumor and the status of regional lymph nodes. Methods: We experienced the 11 cases of laryngeal, tracheal, and bronchial carcinoids during the recent 22 years. We reviewed the locations and histologic features of the tumores, and the clinical characteristics according to them. Results: Most belinged to the central and typical type, respectively. There were laryngeal carcinoid 1 case, tracheal 2 cases and bronchial 8 cases. Females were more common. Hemoptysis which was observed in 4 cases, was found only in the central carcinoids. All bronchial carcinoids showed a mass shadow on the chest X-ray. On flexible bronchoscopic examination, we found the masses in 8 cases and carcinoids were confirmed by biopsy in 7 cases. Invasion to the adjacent organts and distant metastasis were found in 4 cases but the case of atypical carcinoids expired in one month and five of six typical carcinoids were alive. Conclusions: We have an experience that the flexible bronchoscopy is the essential examination for the diagnosis of the central bronchial carcinoids. Even though there is always the risk of massive bleeding, we think that the aggressive biopsy is important. In our study, the incidence of invasion or metastais is relatively high in typical case. Thecase of bilateral kidney metastasis in typical bronchial carcinoid at the time of diagnosis is remarkable.
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경증 기관지 천식 환자에서 Methacholine 흡입에 따른 Spirometer와 Body Plethysmographic Parameter의 변화에 관한 연구
박중원 ( Park Jung Won ),홍천수 ( Hong Cheon Su ) 대한내과학회 1993 대한내과학회지 Vol.44 No.2
Background : Methacholine inhalation test was known to be a good method for assessing the nonspecific bronchial hyperresponsiveness(NSBH). And a decline in forced expiratory volume in 1 second(FEV1) of more than 20% indicates the presence of NSBH. But there are some difficulties in determination of NSBH objectively as the results of spirometry are influenced by ptients motivations. And there are same differences in the mechanisms of airway narrowing between natural bronchial asthma and methacholine induced bronchial spasm. Methods : We measured spirometric and body plethys-mographic parameters both before and after inhalation of methacholine in 30 cases of mild asthmatics. To better understand the mechanism of the methacholine induced bronchospam, spirmetric and plethysmogra-phic parameters of methacholine induced bronchospasm(MIBS, n=18) were compared with natural bronchial asthma(n=18). The MIBS and natural bronchial asthma groups were matched with same predict value of FEV1(65 vs 67%)Results : After the inhalation of methacholine, maximal expiratory flow volume at 50% of total lung capacity(Vmax50) was decreased more than 20% compared to baseline value in all 30 cases and the Vmax25 was decreased more than 20% in 27 of the 30 cases. Inhalation of methaholine produced an 175% increase increase in airway resistance(Raw)and 239% increase in specific airway resistance(SRaw), and all of the 30 cases had an increase in Raw of more than 35 percent. Methacholine inhalation produced a 33.5% increase in residual volume (RV), however the RV was decreased or remained unchange after inhalation of methacholine in 7 out of 30 cases. There were no differences in total lung capacity and effective residual volume between before and after inhalation of methacholine. Vital capacity and diffusing capacity of Co after challenge were significantly decreased 15.1% and 8.7% respectively. With comparison of MIBS(n=18) and natural bronchial asthma(n=18), SRaw was significantly higher in MIBS than natural bronchial asthma (380.±243.7 va 247.8±102.0% of pred.) and no significant difference was found in all spirometric and other plethysmographic parameters. Conclusion : For assessing the NSBH, Raw, Vmax50 and Vmax25 are useful and objective parameters. And even though there are some pathophysologic differences between MIBS and natural bronchial asthma, we could not find significant differences in most parmeters of spirometer and plethysmographic parameters except SRaw between MIBS and natural asthma.
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Vi Capsular Polysaccharide Vaccine 접종 후 Vi 간접형광항체법으로 측정한 항체가의 변화
안광진 ( An Gwang Jin ),김준명 ( Kim Jun Myeong ),김응 ( Kim Eung ),정경섭 ( Jeong Gyeong Seob ),홍천수 ( Hong Cheon Su ) 대한내과학회 1990 대한내과학회지 Vol.38 No.6
N/A The efficacy of purified Vi capsular polysaccharide(CPS) vaccine against typhoid fever has recently been reported in Nepal and South Africa. These results showed approximately 75% protective efficacy, which is at least comparable or superior to other parenteral and oral vaccines. In order to evaluate the immunogenecity of the Vi-CPS typhoid vaccine manufactured at the Merieux Institute in France, we vaccinated healthy young college student volunteers with Vi-CPS, and observed the serial changes of antibody titers for 12 months using the Vi indirect fluorescence antibody test. We observed overall seroconversion in 48.1% of the volunteers, which is lower than other reports, but we found that those with relatively low pre-immunization Vi antibody titers (≤1 : 8) showed 91.7% seroconversion, while those with high pre-immunization titers (≥1 : 16) showed only 13.3% seroconvesion. Booster Vi-CPS vaccine was injected in the nonseroconversion group during a period four months after the first vaccination and followed the Vi antibody titers. The changes of Vi antibody titers were not significant. Moreover, we found that the mean Vi antibody titers between the seroconversion group and the nonseroconversion group were essentially identical from the 30th day after vaccination, with no significant decrease for up to 12 months. Also the adverse effects of the Vi CPS vaccine were negligible compared with other vaccines that are currently available. In conclusion, even though the overall seroconversion rate was lower than previous reports, there was a significant difference in the intensity of the immunogenecity according to pre-immunization Vi antibody titers, and ultimately the antibody titers in both groups became identical showing a sustained plateau for up to 12 months. In order to determine whether the protective efficacy at this acquired level of Vi antibody titers through Vi-CPS vaccination is satisfactory or not, further clinical and epidemiological studies need to be performed.
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