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김용현,윤여일,임건일,박상준,주재학,김용훈,박춘식 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2
Background: Eosinophilic inflammation of airway is usually associated with airway hyperresponsiveness in bronchial asthma. However, there is a small group of patients who has the eosinophilic inflammation in the bronchial tree with normal spirometry and no evidence of airway hyperresponsiveness, which was named eosinophilic bronchitis. The objectives of this study are 1) to investigate the incidence of eosinophilic bronchitis in the chronic cough syndrome and 2) to evaluate the clinical features and course of eosinophilic bronchitis. Methods : We evaluated 92 patients who had persistent cough for 3 weeks or longer. In addition to usual diagnostic protocol, we performed differential cell count of sputum. Eosinophilic bronchitis was diagnosed when the patient had normal spirometic values, normal peak expiratory flow variability, no airway hyperresponsiveness, and sputum eosinophilia(>3%). Result : The causes of choronic cough were post-nasal drip in 33%, cough variant asthma in 16%, bronchitis in 15%, and eosinophilic bronchitis in 12% of the study subjects. Initial eosinophil percentage in sputum of patience with eosinophilic bronchitis was 26.8±6.1% (3.8-63.7%). Treatment with inhaled steroid is related with a subjective improvement of cough severity and a significant decrease of sputum eosinophil percentage (from 29.1±8.3% to 7.4±3.3%)/ During the follow up period of over ? months, recurrence of cough of was associated with reappearance of sputum eosinophilia. Conclusion : Eosinophilic bronchitis is one of the important causes of chronic cough. Assessment of airway inflammation by sputum examination is important in investigating the cause of chronic cough. Cough in eosinophilic bronchitis are effectively controlled by inhaled corticosteroid, but it recurs frequently over a long term period of follow-up(Korean J Med 60:77-84, 2001)
Choon Hak Lim,Youn Suck Koh,Hye Won Lee,Ji Young Khil,Sung Ok Suh,Young Chol Kim,Hae Ja Lim 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Background: Increased intra-abdominal pressure (IAP) leads to adverse effects on most organ systems and is associated with significant morbidity and mortality in surgical and trauma patients. The purpose of this study was to determine the effect of positive end expiratory pressure (PEEP) on IAP and abdominal perfusion pressure (APP, mean arterial pressure, MAP minus IAP) at normal and increased intra-abdominal pressures. Methods: 15 patients requiring a laparoscopic cholecystectomy were included. IAP was measured indirectly using a transurethral catheter, and APP was calculated for each patient at 0, 5, 10, 15, and 20 cmH2O of PEEP, while the insufflator pressure was maintained at either 0 or 15 mmHg. Results: At each insufflator pressure, IAP increased with higher PEEP levels (P < 0.05). At 0 mmHg insufflator pressure state, MAP substantially decreased according to increasing PEEP levels, however, at 15 mmHg insufflator pressure state, MAP substantially increased despite increasing PEEP levels. Meanwhile, APP decreased with increasing PEEP levels at an insufflator pressure of zero while remaining constant at a 15 mmHg insufflator pressure. Conclusions: We found that IAP increases in response to higher PEEP levels (10, 15, and 20 cmH2O) at insufflator pressures of both zero and 15 mmHg in patients anesthetized for laparoscopic cholecystectomy. However, APP did not decrease with increasing PEEP levels at a higher intraadominal pressure (15 mmHg). (Korean J Anesthesiol 2007; 53: S 31∼5)
Lim, Choon Hak,Yang, Sung,Choi, Jae-Wook,Sun, Kyung Blackwell Publishing Inc 2009 Artificial Organs Vol.33 No.11
<P>Abstract: </P><P>The nonpulsatile blood flow obtained using standard cardiopulmonary bypass (CPB) circuits is still generally considered an acceptable, nonphysiologic compromise with few disadvantages. However, numerous reports have concluded that pulsatile perfusion during CPB achieves better multiorgan response postoperatively. Furthermore, pulsatile flow during CPB has been consistently recommended in pediatric and high-risk patients. However, most (80%) of the total hemodynamic energy generated by a pulsatile pump is absorbed by the components of the extracorporeal circuit and only a small portion of the pulsatile energy is delivered to the patient. Therefore, we considered that optimizations of CPB unit and extracorporeal life support (ECLS) system circuit components were needed to deliver sufficient pulsatile flow. In addition, energy equivalent pressure, surplus hemodynamic energy, and total hemodynamic energy, calculated using pressure and flow waveforms, were used to evaluate the pulsatilities of pulsatile CPB and ECLS systems.</P>
Lim, Soo,Kwon, Sung-Youn,Yoon, Ji Won,Kim, So Yeon,Choi, Sung Hee,Park, Young Joo,Yoon, Ho Il,Chang, Yoon Seok,Lee, Jae Ho,Lee, Choon-Taek,Kim, Ki Woong,Park, Kyong Soo,Jang, Hak Chul NAASO, the Obesity Society 2011 Obesity Vol.19 No.3
<P>The age-related increase in body fat and decrease in muscle mass are associated with increased morbidity in elderly populations. Pulmonary function also decreases with age, but no study has investigated whether regional body composition is associated with pulmonary function in an older population. The Korean Longitudinal Study on Health and Aging is a community-based cohort study of people aged > 65 years selected by random stratified sampling. Anthropometrics, biochemical factors, and lung function by spirometry were evaluated in 439 men (mean age of 75.9 ± 8.6 years) and 561 women (mean age of 76.0 ± 8.8 years). Dual-energy X-ray absorptiometry (DXA) was performed to assess the whole and regional body composition. Computed tomography (CT) was also used to measure fat or muscle distribution at the abdominal and mid-thigh levels. Although pulmonary function and muscle mass were inversely related to age, fat mass was not. After adjusting for age, height, BMI, smoking and exercise status, and high sensitivity C-reactive protein (hsCRP), fat mass in trunk or central area was inversely associated with lung function in both sexes (P < 0.01). Men with more muscle in trunk and mid-thigh level had better lung function (P < 0.01). The results of this community-based study show that regional body composition is significantly associated with lung function. Augmentation of muscle in the trunk and low extremity in men, and reduction of fat in the trunk and upper body in men and women may be helpful in maintaining lung function in the elderly population.</P>
Perception of Wheezing in the Elderly Asthmatics
(Jae Hak Joo),(Gun Il Lim),(Moon Jeong Seo),(Sang Joon Park),(Jun Hyek Lee),(Soo Taek Uh),(Yong Hoon Kim),(Choon Sik Park) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.4
N/A Background: In elderly asthmatics, underdiagnosis is one of the important features. The main reason for underdiagnosis is thought to be a low frequency in complaining of symptoms due to the reduction of intellectual recognition and physical activity. Among the various symptoms, wheezing is the principal clue in diagnosing bronchial asthma, and decreased complaints for wheezing are also noted in elderly asthmatics. The objective of this study is to determine if less complaints of wheezing in elderly asthmatic is due to a decrease in the development of wheezing. Methods: 61 young (20-39 years old), 68 middle-aged (40-59 years old) and 65 elderly (older than 60 years old) stable asthmatic subjects were studied (each group shall be called, hereafter, Young Group, Middle-aged Group and Old Group, respectively). During the methacholine induced airway narrowing, lung auscultation and questionnaire survey about presence and perception of wheezing were conducted in 194 asthmatics. Results: One hundred and sixty-nine patients (87%) developed wheezing during the methacholine induced airway obstruction. The frequency of wheezing during the methacholine challenge was found to be comparable among the groups. The methacholine concentration, % fall in FEV1, and FEV1 levels of the initial detection of wheezing were not different among the groups. Among the patients who developed wheezing, 47 patients (77%), 42 patients (61.8%) and 26 patients (40%) complained of wheezing in Young, Middle and Old Group, respectively. Conclusion: In conclusion, the decreased perception of wheezing is a main factor for the low frequency of complaints of wheezing in elderly asthmatics.
( Jae Hyun Ahn ),( Choon Hak Lim ),( Hye In Chung ),( Seong Uk Choi ),( Seung Zoo Youn ),( Hae Ja Lim ) 대한마취과학회 2011 Korean Journal of Anesthesiology Vol.60 No.3
Background: Pneumoperitoneum with an intra-abdominal pressure (IAP) of 14 mmHg is known to decrease renal function. Robotic-assisted radical prostatectomy (RARP) requires an IAP of more than 15 mmHg for operation. Therefore, we retrospectively investigated whether patients who underwent RARP experienced renal insuffi ciency during the postoperative period (at postoperative days 7 and 30). Methods: One hundred patients who underwent RARP were enrolled in this study. Preoperative serum blood urea nitrogen (BUN) and serum creatinine (Cr) levels were measured. Creatinine clearance (CrCl) was calculated using the Cockcroft and Gault formula. CrCl was calculated at 1 day before surgery (baseline), 2 hr postoperatively, and at 1, 3, 7, and 30 days postoperatively (POD 1, POD 3, POP 7, and POD 30). Patients were assigned to abnormal CrCl (n = 52) or normal CrCl groups (n = 48) on the basis of these measurements. Results: Significant inter-group differences in BUN, Cr, and CrCl were observed at all postoperative time points. BUN and Cr decreased significantly at postoperative 2 hr and POD 1, 3, and 7 versus baseline in both groups, whereas CrCl increased significantly at postoperative 2 hr and POD 1, 3, and 7 versus baseline in both groups. However, BUN, Cr, and CrCl were similar at POD 30 and preoperatively in the two groups. Conclusions: RAPR, which requires an IAP of 15-20 mmHg for more than 4 hr, does not induce renal dysfunction during the postoperative period, and even in those patients with an abnormal CrCl. (Korean J Anesthesiol 2011; 60: 192-197)
Koh, Young Jun,Kim, Hak-Zoo,Hwang, Seong-Ik,Lee, Jeung Eun,Oh, Nuri,Jung, Keehoon,Kim, Minah,Kim, Kyung Eun,Kim, Homin,Lim, Nam-Kyu,Jeon, Choon-Ju,Lee, Gyun Min,Jeon, Byeong Hwa,Nam, Do-Hyun,Sung, Hoo Elsevier 2010 CANCER CELL Vol.18 No.2
<P><B>Summary</B></P><P>Two vascular growth factor families, VEGF and the angiopoietins, play critical and coordinate roles in tumor progression and metastasis. A single inhibitor targeting both VEGF and angiopoietins is not available. Here, we developed a chimeric decoy receptor, namely double anti-angiogenic protein (DAAP), which can simultaneously bind VEGF-A and angiopoietins, blocking their actions. Compared to VEGF-Trap or Tie2-Fc, which block either VEGF-A or angiopoietins alone, we believe DAAP is a highly effective molecule for regressing tumor angiogenesis and metastasis in implanted and spontaneous solid tumors; it can also effectively reduce ascites formation and vascular leakage in an ovarian carcinoma model. Thus, simultaneous blockade of VEGF-A and angiopoietins with DAAP is an effective therapeutic strategy for blocking tumor angiogenesis, metastasis, and vascular leakage.</P> <P><B>Highlights</B></P><P>► DAAP simultaneously binds VEGF-A and angiopoietins, and blocks their actions ► DAAP effectively suppresses tumor angiogenesis, metastasis and vascular leakage ► DAAP is superior to VEGF-Trap plus Tie2-Fc in blocking tumor growth and metastasis ► Ang-2 is a therapeutic target to control tumor angiogenesis and vascular leakage</P>