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기관지천식에서 Salbutamol 흡입이 환기기능 및 동맥혈의 산소분압에 미치는 영향
유덕종(Deok Jong Yoo),최정윤(Jung Yoon Choe),권삼(Sam Gweon),이원식(Won Sik Lee),정태훈(Tae Hoon Jung),박희명(Hi Myung Park) 대한내과학회 1987 대한내과학회지 Vol.33 No.4
N/A Effects of salbutamol inhalation were studied in 26 cases of bronchial asthma with particular reference to its main site of action in airways and influence on arterial oxygen tension (PaO2). In l7 cases out of 26, analy of forced expiratory volume and maximal expiratory flow volume curves were made before and 15 minutes after the drug administration, and in 9 of them, physiological dead space (VD/VT) and alveolar-arterial oxygen tension gradient (P(A-a)O2) were also determined 30 minutes after the medication. In the remaining 9 cases, serial determinations of PaO2 were made for 120 minutes following the drug inhalation. Salbutamol inhalation induced a significant improvement in almost all flow parameters and reduction in airway resistance. The alterations of PaO2 a whole, were inversely related to those of P(A-a)O2 whereas the changes in arterial carbon dioxide tension and VD/VT were variable. These facts suggest that in patients with bronchial asthma salbutamol inhalation improves large and small airways function and the changes in PaO2 is mainly results form the alteration of ventilation/perfusion ratio.
Clinical and Bronchoscopic Findings in Ugandans with Pulmonary Kaposi`s Sarcoma
유덕종 ( Deok Jong Yoo ),( Kwan Ho Lee ),( Paula Munderi ),( Kyeong Cheol Shin ),( Jae Kyo Lee ) 대한내과학회 2005 The Korean Journal of Internal Medicine Vol.20 No.4
Background : Pulmonary Kaposi`s sarcoma (PKS) directly affects the life expectancy of those infected and yet the clinical and radiographic features of Kaposi`s sarcoma (KS) with pulmonary involvement are nonspecific, which makes diagnosis difficult. In Uganda, pulmonary tuberculosis, which has clinical features that closely resemble those of PKS, also occurs commonly and thus confusion is bound to arise. Bronchoscopy is a recognized diagnostic investigatory modality for PKS. The aim of present study was to identify unique or useful points for the differential diagnosis of PKS and other opportunistic infections. Methods : The clinical, radiologic, and bronchoscopic findings in thirty-five Ugandan patients (age 20-50, median 32) with PKS were analyzed. Results : Cough and weight loss were most common and occurred in 97.1%, whereas fever occurred in 62.9%, and breathlessness in 57.1%. Thirty-four patients (97.1%) showed mucocutaneous KS, and palatal KS was most frequent and was observed in 74.3%. In addition, 25 patients (71.4%) showed the characteristic endobronchial plaques of KS. The most frequently observed radiographic abnormality was bilateral reticulonodular density. Histological examinations of bronchoscopic biopsies revealed KS in 7 (36.6%) cases. Five PFS patients (25%) also had co-existent tuberculosis. Conclusions : The majority of patients with PKS showed no specific findings on physical examination, apart from mucocutaneous KS. Our findings indicate that palatal KS may be a strong predictor of PKS. In Uganda, pulmonary tuberculosis may be the most common concomitant pulmonary infection in PKS patients.
결핵 및 만성폐새성폐질환에 의한 폐성심의 환기력학의 차이
이원식,박희명,정태훈,김교선,유덕종,손명원 대한내과학회 1986 대한내과학회지 Vol.30 No.1
Ventilatory dynamics were studied in R2 cases of cor pulmonale caused by either chronic obstructive pulmonary disease(COPD) or far advanced pulmonary tuberculosis, with particular reference to differences in airways dysfunction between two groups. Ventilatory functions tested in this study were analyses of forced expiratory volume curves, maximal expiratory flow volume curves and determinations of closing volume with its ratio to vital capacity. The degree of airways obstruction as determined by the parameters derived from forced expiratory and maximal expiratory flow volume curves, observed and volume-adjusted, showed no significant difference between two groups, except for fast vital capacity which was significantly larger in the latter. The closing volume was significantly larger in patients with cor pulmonale due to COPD than in the other, hut its ratio to vital capacity showed no significant difference between two groups. Comparison of vital capacity and fast vital capacity in patients with COPD with and without cor pulmonale were insignificant. In contrast, these two parameters in patients with far advanced pulmonary tuberculasis with cor pulmonale were significantly smaller than in those without, and the degree of reduction in vital capacity in those with cor pulmonale was as much as 50 percent on the average. This suggests that in patients with pulmonary tuberculosis advanced to the extent to cause cor pulmonale is associated with destruction of approximately half of the lung tissues as reflected by vital capacity. The findings also suggest that in patients with cor pulmonale due to pulmonary tuberculosis, there is definite and considerable large and small airways obstruction similar to that in the other group, as well as restrictive ventilatory impairment.
이원식,정태훈,김교선,이국희,유덕종,손명원 대한내과학회 1986 대한내과학회지 Vol.30 No.2
The diagnostic value of transbronchial lung biopsy(TBLB) through fiberoptic bronchoscope was studied in 61 patients with diffuse or localized lung disease in which routine clinical and laboratory examinations revealed no diagnostic clue. By the technique adequate tissue specimen for diagnosis was obtainable in 28 of 33 patients (78.8 percent) and 25 of 28(89.3 percent) with localized and diffuse lung diseases, respectively. A histological diagnosis was possible in more than 75 percent of the patients with lung cancer proved by various means. On the other hand, in patients with tuberculous lesions, diffuse or localized, the incidence of positive diagnosis was less than a half. The complications among 61 patients underwent the TBLB were pneumothorax in one and hemoptysis in three, which subsided spontaneously. These facts suggest that the TRLB is a relatively safe, and more useful in the diagnosis of cancer of the lung than in inflammatory disease.