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만성폐쇄성폐질환의 치료에서 서방형 Theophylline 의 1 일 1 회 제형과 1 일 2 회 제형의 비교
이양덕(Yang Deok Lee),이흥범(Heung Bum Lee),이용철(Yong Chul Lee),이양근(Yang Keun Rhee) 대한내과학회 2002 대한내과학회지 Vol.62 No.2
N/A Background: Theophylline is a weak bronchodilator with a narrow therapeutic window. Much of its clinical benefit derives from effects other than bronchodilaton; therapeutic doses of theophylline increase ventilatory drive, enhance diaphragmatic contractility and increase cardiac output. About 20% of COPD patients respond to theophylline with improved airflow, exercise tolerance and quality of life. Generally it is prescribed as a twice-daily equal-dose regimen so as to produce nearly constant blood level throughout each 24 hour. We compared 12-hour and 24-hour sustained-release theophyllines in the management of chronic obstructive pulmonary disease. Methods: A crossover study was conducted with 27 adult chronic obstructive pulmonary disease requiring daily bronchodilator therapy. The study group included nineteen males and eight females ranging in age from 48 to 71 years. The overall approach was to place the patients first on the twice-daily preparation (Etheophyl?) for 28 days at 8 AM and 8 PM and pulmonary function tests and theophylline level were measured on the 28th day. The patients were subsequently switched to the once-daily preparation (Uniphyl?) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. Results : The mean serum levels of theophylline were 8.80±2.64 μg/mL in the Etheophyl?- treated and 8.48±2.08 μg/mL in the Uniphyl?-treated period. And the FEV1 showed 63.72±8.63% in the Etheophyl?-treated and 62.81±9.81% in the Uniphyl?-treated period. Conclusion: The results suggested that there was little clinical differences between the two medications. The two drugs were equally effective in clinically controlling COPD over the four weeks of treatment.(Korean J Med 62:182-186, 2002)
흉곽내 병변의 진단에 절단침과 세흡인침을 이용한 경피적 침생검술의 비교
이양근(Yang Keun Rhee),곽재용(Jae Yong Kwak),송정선(Jeong Sun Song),김재헌(Jae Hean Kim),유관희(Kwan Hee You),이용철(Yong Chul Lee),한영민(Young Min Han) 대한내과학회 1996 대한내과학회지 Vol.51 No.3
N/A Objectives: Percutaneous needle biopsy in the most reliable invasive method of obtaining the confirm diagnosis of peripheral pulmonary nodule. Needle aspiration combinde with cytologic examination is being used with increasing frequency in the diagnosis of pulmonary nodules and masses. Percutaneous needle lung biopsy was done in pulmonary or mediastinal lesions using 19 Gauge fine aspiration needle or 14 Gauge cutting needle, and the results were compared with respect to diagnostic accuracy and complications. Methods: Over a periods of recent ten years. 476 patients who had localized pulmonary lesions and underwent percutaneous needle lung aspiration and biopsy using 19 Gauge fine aspiration needle or 14 Gauge cutting needle. Results: The age distribution of the patients was from sixteen to eighty-one years old. Among 467 patients, 337 patients were male and 130 patients were female. In 244 patients, sizes of the lesions were less than 4cm, in largest diameter, and in 223 patients, sizes of the lesions were larger than 4cm, but the size of the lesion was not correlated with malignancy. Diagnosic yields of the 14 Gauge cutting needle and the 19 Gauge fine needle were 88.3% and 78.3% respectively. Success rate of benigm and malignant lesion was more higher in 14 Gauge cutting needle than 19 Gauge fine aspiration needle. Common diseases were priamry lung cancer, tuberculoma, abscess in order of frequency. The complications of procedure were mild pneumothorax in ten patients, mild hemoptysis in six patients and subcutaneous emphysema in one patient. With Cutting needle and aspiration needle, complication rate was 2.73% and 2.36%, respectively. Conclusion: Percutaenous needle lung biopsy with cutting needle under the chest computed tomogram and biplane fluoroscopy had lower complication rate and high diagnostic success rate for the intrathoracic lesions
강섬유 혼입율이 강섬유보강 고강도 콘크리트의 작업성과 강도특성에 미치는 영향
김윤일,이양근,김명성,Kim, Yoon-Il,Lee, Yang-Keun,Kim, Myung-Sung 한국건축시공학회 2008 한국건축시공학회지 Vol.8 No.3
In this paper, concrete material tests were carried out to investigate influence of steel fiber volumn ratios on variations of workability and strength characteristics of steel fiber reinforced high-strength concrete, $50MPa{\sim}90MPa$ of compressive strength, according to increase of fiber volume. Test specimens were arranged with six levels of concrete compressive strength and fiber volumn ratios, 0.0%, 0.5%, 1.0%, 1.5%, 2.0%. The test results showed that steel fiber reinforced high-strength concrete($70MPa{\sim}90MPa$, 1.5% fiber volumn ratio) with good workability of slump 20cm could be used practically and effects of steel fiber reinforcement in improvement of concrete strength and toughness characteristics such as splitting tensile strength, flexural strength, and diagonal tensioned shear strength, were more distinguished in high-strength concrete than general strength concrete. And the test results indicated that splitting tensile strength of fiber reinforced concrete was proportioned to the product of steel fiber volumn ratios, $V_f(%)$ and sqare root of compressive strength, $\sqrt{f_{ck}}$, and the increasing rate was in contrast with that of flexural strength, and increase of diagonal tensioned shear strength was remarkable at steel fiber volumn ratio, 0.5%.
수영 , 마라톤 , 농구와 역도 선수에서의 운동 부하 폐 기능 검사
이용철(Yong Chul Lee),전창호(Chang Ho Jeon),이양근(Yang Keun Rhee) 대한내과학회 1994 대한내과학회지 Vol.46 No.3
N/A Objectives : Exercise tests are being more widely applied in the investigation of cardiac and pulmonary disorders. To evaluate patients with exertional dyspnea, clinicians need to know the range of expected performance during exercise in normal subjects from an appropriate population. To define the normal various response to exercise, we studied exercise tests for maratoner, swimmer, basketball player, weight leaftner and no athelets group (control group). Method: Underwent a progressively incremental exercise test to a symptom-limited maximum. Measurement were made of O2 intake and CO2 output, ventilation and breathing pattern, heart rate, blood pressure and rating of perceived exertion. Results: Maximal O2 intake of swimmer, maratoner was significantly higher than control group, but maximal O2 intake of basketball player, weight leaftner was no different to control group. The anaerobic threshold was detected in all players and control group. The anaerobic threshold of basketball player, swimmer and maratoner was significantly higher than control group and weight leaftner, but the ratio of anaerobic threshold and the predicted maximal oxygen uptake was not different in control group and all players except basketball player. Conclusion: In the interpretaion of exercise test on normal person, varieties of exercise and training are reliable predictor of maximal exercise capacity.
이용철(Yong Chul Lee),이양근(Yang Keun Rhee) 대한내과학회 1991 대한내과학회지 Vol.41 No.4
N/A Inhaled budesonide is known to be effective for chronic asthma and chronic obstructive airway disease. Budesonide is a nonhalogenated glucocorticoid with hight local activity and low systemic effects due to rapid inactivation in the liver. The biotransformation of budesonide in the liver is 4-5 times faster than that of beclomethasone dipropionate. The hypothalamicpituitary-adrenal axis mediates response to stress, circadian rhythm, and negative feedback of the glucocorticoids to the adrenal cortex. Both endogenous and exogenous glucocorticoids act via the hypothalamic and pituitary to reduce cortisol secretion by the adrenal glands. Inhaled corticosteroids may produce systemic effects which include decreased hypothalamicpituitary-adrenal axis activity. The authors measured plasma cortisol at 0800hr and 24hr urinary-free cortisol values in 12chronic obstructive pulmonary disease patients and 7 branchial asthma patients. During the pretreatment period of 10 days, no steroids were taken. During the treatment period (days 1-12), each subject inhaled budesonide aerosol 2times a day (1600㎍/day). A measurement of basal adrenal activity showed that both 24hr urinary-free cortisol and 0800hr plasma cortisol decreased by the third day of steroid treatment. All 17subjects had a decrease in adrenal basal activity. The result indicate that suppression of endogenous cortisol secretion occurs at budesonide doses of 1600㎍/ day and 800㎍/day.
만성 폐쇄성 폐질환 , 기관지천식 환자에서의 운동부하 폐기능검사
이용철(Yong Chul Lee),김원(Won Kim),임석태(Seok Tae Lim),이흥범(Heung Bum Lee),김현중(Hyun Jung Kim),이제경(Je Kyung Lee),송현모(Hyun Mo Song),이양근(Yang Keun Rhee) 대한내과학회 1996 대한내과학회지 Vol.50 No.6
N/A Objectives: Exercise tests are being widely applied to objective measurement of work capacity, identification and quantification of cardiopulmonary mechanics in the cardiac and pulmonary disorders. To evaluate patients with exertional dyspnea in bronchial asthma and chronic obstructive pulmonary disease (COPD), clinicians need to know the range of expected performance during exercise. To define the various response to exercise, we studied exercise tests in clinically stable asthma and chronic obstructive pulmonary disease. Methods: Twenty healthy subjects, twenty controlled bronchial asthma patients, and twenty five chronic airway obstructive patients underwent progressively incremental exercise test to the symptom-limited maximum. Measurement were made of O₂uptake and CO₂ ouptput, heart rate, breathing rate, anaerobic threshold, minute ventilation, maximal O₂pulse and dead space during exercise test. Results: 1) The maximal oxygen uptake, maximal CO₂production, maximal oxygen pulse, minute ventilation, and breathing reserve in COPD patients were significantly lower than that of normal subjects. 2) The heart rate reserve and dead space at maximal exercise in COPD patients were significantly highter than those of normal controls. 3) The anaerobic threshold was detectable in 8 of 25 COPD patients. The ratio of anaerobic threshold to maximal oxygen uptake was not different from that of nomal subjects. 4) The maximal oxygen uptake, maximal Co₂output, maximal oxygen pulse, minute ventilation, breathing reserve, heart rate reserve, dead space at maximal exercise, anaerobic thre shold and ratio of anaerobic threshold in controlled bronchial asthmatics were not different form those of normal subjects, Conclusion: The exercise capacity is decreased in chronic obstructive pulmonary disease. But, there is no difference between nomal controls and controlled asthmatic patients in exercise capacity. This result suggest that exercise capacity of controlled asthmatic patients is not decreased.