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이양덕 ( Yang Deok Lee ),조용선 ( Yong Seon Cho ),한민수 ( Min Soo Han ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.5
The prevention of and the controlling of symptoms, reductions in the frequency of exacerbations, and disease severity are central to the pharmacologic therapy of chronic obstructive pulmonary disease (COPD). COPD patients are inclined to be older, have more comorbidities, and use polypharmacy as a result. Long-acting inhaled muscarinic antagonists (LAMAs) is a preferred treatment modality. However, the cardiovascular (CV) safety of anti-cholinergics, including LAMA, has been an issue. In contrast, the results of the UPLIFT trial and a pooled analysis of data from 30 trials of tiotropium illustrates the association of tiotropium with reductions in the risk of all cause mortality, CV mortality and CV events. And, the UPLIFT trial provides clues regarding the additive advantages of tiotropium in COPD patients who already are using long-acting inhaled β2 agonists and inhaled corticosteroids. Following the contribution of tiotropium as a first LAMA, new LAMAs such as aclidinium and glycopyrrolate (NVA-237) seem to be emerging.
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)
이양덕(Yang Deok Lee),송은기(Eun Kee Song),최정기(Jeong Ki Choi),이승옥(Seung Ok Lee),이수택(Soo Teik Lee),안득수(Deuk Soo Ahn) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.2
Although Meckel’s diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain completely asymptomatic, or it may mimic disorders such as Crohn’s disease, appendicitis, and peptic ulcer disease. Approximately 50 percent of all Meckel’s diverticula contain ectopic tissue, which consists of gastric tissue in 60 to 85 percent of the cases and pancreatic tissue in 5 to 16 percent. Meckel’s diverticulum should be considered in diagnosing patients with unexplained abdominal pain, nausea and vomiting, or intestinal bleeding. Major complications include bleeding, obstruction, intussusception, diverticulitis, and perforation. It can be treated by surgical resection. Here, we report a case of chronic intussusception induced by Meckel’s diverticulum in adult which we recently experienced. (Korean J Gastroenterol 2001;38:132-135)
이양덕(Yang Deok Lee),박성광(Sung Kwang Park),강성귀(Sung Kyew Kang) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.2
A resurgence of milk-alkali syndrome is attributable to increases in calcium therapy for the treatment of osteoporosis in postmenopausal women and hyperphosphatemia in chronic renal failure. In Korea, traditionally ox's bone extract is used to treatment of arthralgia, degenerative arthritis, and nutritional supplements. We treated one woman who presented with the triad of hypercalcemia, metabolic alkalosis, and renal failure after ingestion of ox's bone extract. All metabolic abnormalities were normalized, and renal function improved with supportive measures and cessation of ox's bone extract.
노인환자의 기도가역성 검사에서 FEV<sub>6</sub>의 보완적 지표로서의 역할
김새희,이양덕,이정윤,조용선,나동집,한민수,Kim, Sae Hee,Lee, Yang Deok,Lee, Jung Yun,Cho, Yong Seon,Na, Dong Jip,Han, Min Soo 대한결핵및호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3
연구배경: 기도가역성 측정시, 1초간 노력성 호기량(forced expiratory volume in one second, $FEV_{1}$)과 노력성 폐활량(forced vital capacity, FVC)은 흔히 사용되는 지표인데 양성반응의 권장기준은 기저치보다 증가치가 절대량이 200ml이상 그리고 백분율로는 12%이상의 두 조건을 다 만족하는 것이다. 그러나 노인 환자는 천식에 합당한 병력을 가지고 있어도 기도가역성의 진단기준을 만족시키지 못하는 경우가 종종 있다. 저자들은 6초간 노력성 호기량($FEV_{6}$)이 노인의 기도가역성 검사에서 역할을 알아보고자 하였다. 방 법: 65세 이상의 노인환자 중 폐기능검사에서 $FEV_{1}$/FVC가 80%미만인 236명에게 폐활량측정법으로 기도가역성 검사를 시행하였다. 기저 $FEV_{1}$에 따라 다음과 같이 세 군으로 분류하였으며 각 군에서의 FVC, $FEV_{6}$, $FEV_{1}$의 지표에 따른 기도가역성를 비교분석하였다. 제1군 : $$FEV_{1}{\geq_-}80%$$, 제2군 : $FEV_{1}$ 60~80%, 제3군 : $$FEV_{1}{\leq_-}60%$$ 결 과: 전체 환자에서 기도가역성은 각각의 지표에 따라 $FEV_{1}$에서는 33명(14.0%), $FEV_{6}$는 55명(23.3%), FVC는 55명(23.3%)로 양성반응을 보였고, 제3군($$FEV_{1}{\leq_-}60%$$)에서는 $FEV_{1}$을 지표로 할 때는 15명(22.4%), $FEV_{6}$는 30명(44.8%), FVC는 32명(47.8%)으로 나타났다. 결 론: 본 연구에서는 $FEV_{6}$가 노인환자에서 기도가역성 검사의 새로운 보완적 지표로서의 역할을 보여줬지만 이의 일반화를 위해서는 좀 더 많은 연구가 필요할 것이다. Background: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second($FEV_{1}$) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds($FEV_{6}$) in the bronchodilator reversibility test in elderly patients. Methods: A total of 236 patients more than 65 years of age with a $FEV_{1}$/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting $FEV_{1}$ as the baseline, the patients were divided into three groups; Group I : $$FEV_{1}{\geq_-}80%$$ of the predicted value, Group II : 60%<$FEV_{1}$<80% of the predicted value, Group III : $$FEV_{1}{\leq_-}60%$$ of the predicted value. Results: Positive reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively. Conclusions: The $FEV_{6}$ might be used as a complementary parameter in bronchodilatror reversibility in elderly patients. However, more study will be needed to determine the usefulness of $FEV_{6}$ in bronchodilator reversibility test.
문유리 ( You Ri Moon ),이양덕 ( Yang Deok Lee ),박상현 ( Sang Hyun Park ),조용수 ( Yong Soo Cho ),나동집 ( Dong Jib Na ),조용선 ( Yong Seon Cho ),한민수 ( Min Soo Han ),최희정 ( Hee Jeong Choi ),김도형 ( Do Hyung Kim ),양승오 ( Se 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.6
Positron emission tomography/computed tomography (PET/CT) is valuable for the diagnosis of malignancies. However, PET/CT is unable to discriminate exactly between inflammation and a neoplasm. We report a case of a 50-year-old man with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by PET/CT. The use of PET/CT revealed multilobulated consolidation on the right lung and patchy consolidation on the left lung, with increased fluorodeoxyglucose (FDG) uptake. In addition, the left paraaortic lymph node (LN) and peripancreatic LN showed enlargement with increased FDG uptake. Lung cancer with multiple lymph node metastases was suspected from the increased standardized uptake values (SUV>4.5) determined by PET/CT. We performed wedge resection via video-assisted thoracic surgery (VATS) and found Paragonimus westermani eggs in the involved tissues. (Tuberc Respir Dis 2007;63:521-525)
이민경 ( Min Kyung Lee ),나동집 ( Dong Jib Na ),전호석 ( Ho Seok Jeon ),이양덕 ( Yang Deok Lee ),조용선 ( Yong Seon Cho ),한민수 ( Min Soo Han ),윤희정 ( Hee Jeong Yoon ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.1
We emphasizes the fact that isoniazid could lead to the development of gynecomastia. Physicians should be aware of this rare adverse effect.
노인환자의 기도가역성 검사에서 FEV6의 보완적 지표로서의 역할
김새희 ( Sae Hee Kim ),이양덕 ( Yang Deok Lee ),이정윤 ( Jung Yun Lee ),조용선 ( Yong Seon Cho ),나동집 ( Dong Jip Na ),한민수 ( Min Soo Han ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3
연구배경 : 기도가역성 측정시, 1초간 노력성 호기량(forced expiratory volume in one second, FEV1)과 노력성 폐활량(forced vital capacity, FVC)은 흔히 사용되는 지표인데 양성반응의 권장기준은 기저치보다 증가치가 절대량이 200㎖이상 그리고 백분율로는 12%이상의 두 조건을 다 만족하는 것이다. 그러나 노인 환자는 천식에 합당한 병력을 가지고 있어도 기도가역성의 진단기준을 만족시키지 못하는 경우가 종종 있다. 저자들은 6초간 노력성 호기량(FEV6)이 노인의 기도가역성 검사에서 역할을 알아보자고 하였다. 방법: 65세 이상의 노인환자 중 폐기능검사에서 FEV1/FVC가 80%미만인 236명에게 폐활량측정법으로 기도가역성 검사를 시행하였다. 기저 FEV1에 따라 다음과 같이 세 군으로 분류하였으며 각 군에서의 FVC, FEV6, FEV1의 지표에 따른 기도가역성을 비교 분석하였다. 제1군 : FEV1≥80%, 제2군 : FEV1 60~80%, 제3군 : FEV1≤60% 결과: 전체 환자에서 기도가역성은 각각의 지표에 따라 FEV1에서는 33명(14.0%), FEV6는 55명(23.3%), FVC는 55명(23.3%)로 양성반응을 보였고, 제3군(FEV1≤60%)에서는 FEV1을 지표로 할 때는 15명(22.4%), FEV6는 30명(44.8%), FVC는 32명(47.8%)으로 나타났다. 결론: 본 연구에서는 FEV6가 노인환자에서 기도가역성 검사의 새로운 보완적 지표로서의 역할을 보여줬지만 이의 일반화를 위해서는 좀 더 많은 연구가 필요할 것이다. Background: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second(FEV1) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200㎖ and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200㎖) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds(FEV6) in the bronchodilator reversibility test in elderly patients. Methods: A total of 236 patients more than 65 years of age with a FEV1/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting FEV1 as the baseline, the patients were divided into three groups; Group I : FEV1≥80% of the predicted value, Group II : 60%<FEV1<80% of the predicted value, Group III : FEV1≥60% of the predicted value. Results: Positive reversibility in the FEV1, FEV6, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the FEV1, FEV6, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively. Conclusions: The FEV6 might be used as a complementary parameter in bronchodilator reversibility in elderly patients. However, more study will be needed to determine the usefulness of FEV6 in bronchodilator reversibility test. (Tuberc Respir Dis 2006; 61: 227-232)