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유빈(Bin Yoo),정희순(Hee Soon Chung),한성구(Sung Koo Han),심영수(Young Soo Shim),김건열(Keun Youl Kim),한용철(Yong Chol Han) 대한내과학회 1987 대한내과학회지 Vol.32 No.5
N/A Carcinoma of the lung is generally considered as a disease of middle age and elderly. But lung cancer is now so prevalent that patients below the age of 40 years must be increaseing. We reviewed the records of 483 lung cancer patients who had been diagnosed in the department of internal medicine of Seoul National University Hospital from March 1984 to February 1986, and the clinical features of the young patients under 40 years were compared with those of the control group patients over 40 years. The results are summarized as follows; 1) Seven percent of 34 cases of 483 patients were belong to the young age group patients (less than 40 years). The youngest patient was 22 years old. 2) Male to female ratios of young group and the control group were 3.25:1, 5.9:1 respectively (p>0.05). 3) The mean duration of symptoms from the onset to the definite diagnosis was 2.7 months in young group and 2.3 months in the control group (p>0.3). 4) The most common initial symptoms in the young group were dyspnea (26.5%), hemoptysis (20.5%), cough or sputum (20.5/), chest pain (8.8%) which were also the most common initial symptoms in the control group. (p>0.25) The incidence of superior vena cava syndrome was significantly higher in the young age group (23.5%) than in the control group (7.1%) (p<0.05). 5) In the young group, the proportion of adenocarcinoma (35%) was significantly higher than that of the control group (18%) (p<0.05). 6) The proportion of smoker was significantly lower in the young age group (13 cases, 38.2%) than in the control group (77.7%). The histological type of 13 smokers of the young group was squamous cell carcinoma in 12 cases and adenocarcinoma in 1 case. 7) All non-small cell lung cancer patients in young group were belong to stage III. 8) Distant metastasis rate of the young group (74%) was significantly higher than that of the control group (54.8%) (p<0.05).
고연령층에서의 세포성면역의 변화에 관한 연구 - 비특이적 자극에 대한 T - 세포와 폐포대식세포의 반응을 중심으로 -
한성구(Sung Koo Han),이계영(Kye Young Lee),최형석(Hyung Seok Choi),정희순(Hee Soon Chung),김영환(Young Whan Kim),심영수(Young Soo Shim),김건열(Keun Youl Kim),한용철(Yong Chol Han) 대한내과학회 1994 대한내과학회지 Vol.46 No.6
N/A Background: T-cells and macrophages are the two elements that play the key roles in cell-mediated immunity. Based on the evidences for the involution of thymus occuring as the age become older, the cell-mediated immunity is expected to be altered in geriatric population. Moreover, the T-cell proliferatve response to non-specific stimulants such as phytohemagglutinin (PHA) is known to be decreased in aged population. However, there has been no convincing evidences for the functional decline of macrophages in aged population. The alterations of immune system accompanied by the increase in age have the clinical significances in that the geriatric population is much more susceptible to the diseases such as infectious, neoplastic, and autoimmune diseases where the immune system is proved to play a great role in their pathogenesis. To evaluate the alteration of cell-mediated immunity in old age, we investigated the responses of T-cell and alveolar macrophages from healthy geriatric population, and compared them with those of the young control population. Method: To evaluate the alterations of T-cell function, lymphoblastogenesis in response to concanavalin-A (Con-A) and PHA was measured by 3H-thymidine incorporation method and high affinity IL-2 receptor expression (Tac antigen) after stimulation with PHA was measured by flow cytometry using peripheral blood mononuclear cells from young and old age group, respectively. To evaluate the alterations of macrophage function, superoxide anion productions by alveolar macrophages both in basal state and in response to phobol myristate acetate (PMA) were measured and the priming effect of interferon-gamma was also compared. Results: 1) The lymphoblastogenesis in response to Con-A and PHA was significantly depressed in old age group compared with young control group. 2) The expression of high affinity IL-2 receptor after stimulation with PHA was also significantly depressed in old age group. 3) There was no difference in the superoxide anion production by alveolar macrophages between old age group and young control group both in basal state and after PMA stimulation. 4) There was no priming effect of interferon-gamma pretreatment in both old age group and young control group. Conclusion: The functional defect of T-cells associated with aging is evident but that of alveolar macrophages is not conclusive. It is suggested that the alterations of T-cells play a more important role than macrophages in the depression of cell-mediated immunity accompanied by aging process than macrophages but there remain many palces of further investigation in the functional changes of macrophages associted with aging.
객혈의 원인질환 진단에 있어서 고해상도 CT 의 역할에 관한 연구
박계영(Gye Young Park),모은경(Eun Kyung Mo),이계영(Kye Young Lee),유철규(Chul Gyu Yoo),김영환(Young Whan Kim),한성구(Sung Koo Han),심영수(Young Soo Shim),김건열(Keun Youl Kim),한용철(Yong Chol Han) 대한내과학회 1995 대한내과학회지 Vol.48 No.4
N/A Objectives: The etiology of hemoptysis is often uncertain even after intensive diagnostic workup. The HRCT is a useful diagnostic tool in the evaluation of pulmonary parenchymal diseases. The purpose of this study is to evaluate the usefulness of HRCT in patients with hemoptysis who show normal or non-specific chest x-ray findings. Methods : 60 patients with hemoptysis on whom both bronchoscopy and HRCT were performed between January of 1988 and June of 1992 were evaluated retrospectively by analysing clinical charcteristics, simple radiologic findings, bronchoscopic findings, pathologic results and bacteriologic studies, and HRCT findings. Results: 1) The final clinical diagnoses were bronchiectasis (63.3%), followed by pulmonary tuberculosis(18.3%), fungus ball(8.3% ), malignant tumor(5% ), and others(5% ), 2) The bronchoscopy could localize the site of bleeding in 15 out of 60 patients(25% ) 3) Among 24 patients with normal bronchoscopic finding, HRCT was helpful in making the diagnosis in 21 patients. 4) In 57 out of 60 patients (95%), HRCT findings were compatible with or suggestive of the final clinical diagnosis. Conclusion: HRCT could be a useful tool in the evaluation of hemoptysis especially in patients with normal or non specific chest x- ray findings.