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한 대학병원에서 급성 폐색전증으로 진단된 환자들의 임상적 특성 및 예후
채진녕 ( Jin Nyeong Chae ),최원일 ( Won Il Choi ),박지혜 ( Jie Hae Park ),조병학 ( Byung Hak Rho ),김재범 ( Jae Bum Kim ) 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.3
Background: Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced. Methods: We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis. Results: The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%). Conclusion: PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.
결핵성 파괴폐의 흉부 전산화단층촬영 소견 및 폐기능과의 상관관계
채진녕 ( Jin Nyeong Chae ),정치영 ( Chi Young Jung ),심상우 ( Sang Woo Shim ),노병학 ( Byung Hak Rho ),전영준 ( Young June Jeon ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.3
Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=?0.379, p=0.001) and forced expiratory volume in one second (FEV1), % predicted (r= ?0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=?0.070, p=0.014) and FEV1, % predicted (B=?0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.