No abstract available.
Pulmonary Disease, Chronic Obstructive*

BACKGROUND: In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of FEV1 in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of FEV1 especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and FEV1 in healthy children. METHOD: PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children (age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of FEV1 by PEF were derived. RESULTS: 1. The regression equation for PEF(L/min) was:12.6×age(year)+3.4×height(cm)-263(R2=0.85) in boys, and 6×age(year)+3.9×height(cm)-293(R2=0.82) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for FEV1(ml) by PEF(L/min) was:7×PEF-550(R2=0.82) in boys, and 5.8×PEF-146(R2=0.81) in girls, respectively. CONCLUSION: This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for FEV1, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.
Airway Obstruction ; Asthma ; Child* ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Reference Values

PURPOSE: As one of the new chemotherapeutic agents, gemcitabine is widely used as a four-week schedule in combination with cisplatin in the treatment of advanced non-small-cell lung cancer (NSCLC). In this study, we evaluated the efficacy, tolerance, and survival effect of this combination in a three-week schedule in patients with locally advanced inoperable or metastatic NSCLC. MATERIALS AND METHODS: Between January 2000 and September 2002, previously untreated 124 NSCLC patients were enrolled and 118 patients, who completed at least two cycles of chemotherapy, were evaluated. Patients received gemcitabine 1200 mg/m2 on days 1 and 8, cisplatin 75 mg/m2 on day 1 of a 21-day cycle, for a maximum of 6 cycles. RESULTS: They were 81 men and 37 women. Clinical stage IIIB was present in 56 (47.5%), and stage IV in 62 (52.4%) patients. Sixty-seven patients (56.8%) had a performance status of ECOG grade 0 or 1 and fifty-one patients (43.2%) of grade 2. During the period of chemotherapy, grade 3/4 leukopenia and neutropenia were observed in 19.5% and 31.4%, respectively and grade 3/4 thrombocytopenia in 7.6%. The overall response rate was 52.5% among the 118 patients. Overall median survival time was 12.2 months, and one-year and two-year survival rates were 50.2% and 20.4% respectively. The presence of response to chemotherapy, ECOG performance status of grade 0~1, and women showed better survival by the univariate analysis (p=0.010, 0.001 and 0.015, respectively). CONCLUSION: A three weekly gemcitabine/cisplatin doublet was relatively well tolerated, with an acceptable response rate and a reasonable median survival in locally advanced inoperable or metastatic NSCLC.
Appointments and Schedules ; Cisplatin* ; Drug Therapy* ; Female ; Humans ; Leukopenia ; Lung Neoplasms* ; Lung* ; Male ; Neutropenia ; Survival Rate ; Thrombocytopenia

BACKGROUND: We conducted a study to determine the factors associated with, patterns of, and proportion of cases of pulmonary tuberculosis with multiple drug-resistance at Kosin medical center in Pusan. METHODS: We abstracted data from 141 patients, who had active pulmonary tuberculosis and report forms of drug susceptibility between 1986 and 1994, and related the previous treatment history, the extent of lung involvement and the presence of cavities on chest X-ray films to the drug resistance. RESULTS: Overall, 59(41.8%) of the 141 cases of tuberculosis were resistant to at least one drug and 29(20.9%) of the 139 cases were resistant to isoniazid(INH) and rifampin(RIF). Among the 63 patients with previous tuberculosis therapy, 40(63.5%) had isolates that were drug-resistant and 24(38.1%) were multi-drug resistant. Among the 78 without previous therapy, 19(24.4%) had isolates that were drug-resistant and 5(7.5%) were multi-drug resistant. For all 141, resistance to INH was most common(39.0%) followed by RIF(21.6%), ethambutol(EMB, 16.3%), p-aminosalicylic acid(10.8%), streptomycin(SM, 8.7%), and pyrazinamide(PZA, 8.0%). INH, RIF and PZA resistances were independently associated with a history of previous tuberculosis therapy (odds ratio; 3.3, 7.2 and 10.8 respectively), and RIF and SM resistance were significantly high according to the extent of lung involvement on the chest films(odds ratio; 2.9 and 2.8 respectively). CONCLUSIONS: We conclude, (1) that all persons in whom pulmonary tuberculosis is diagnosed should initially receive at least four-drug therapy(INH, RIF, PZA, and EMB or SM), (2) that susceptibility testing be done in all culture-positive patient, and (3) that those with a history of previous tuberculosis therapy or those who have advanced pulmonary tuberculosis need very careful clinical and microbiological follow-up.
Busan ; Drug Resistance ; Follow-Up Studies ; Humans ; Lung ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary* ; X-Ray Film

BACKGROUND/AIMS: Lung cancer is the leading cause of cancer death worldwide. There are significant gender differences in lung cancer: most females with lung cancer are non-smokers and they are diagnosed with adenocarcinoma. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are more effective in female lung cancer patients, but the results with gefitinib and erlotinib differ. This study compared the therapeutic response and toxicity of gefitinib and erlotinib in female lung cancer patients. Method: We retrospectively reviewed the clinical information on patients treated with gefitinib or erlotinib for more than one month at Kosin University Gospel Hospital from February 2004 to November 2007. RESULTS: Forty-two patients (26 gefitinib vs. 16 erlotinib) were enrolled during this period. Their median age was 58 years. Thirty-six patients (85%) were non-smokers and 35 patients (83%) had adenocarcinoma. There were 24% at stage IIIb and 76% at stage IV. The median survival time was 793 days. In the gefitinib group, 69% of the patients received 3rd-line chemotherapy, while 12 of 16 (87.5%) in the erlotinib group received 2nd-line chemotherapy. There were no significant differences in the overall response rate (gefitinib 39% vs. erlotinib 31%, p=0.524), median survival time (gefitinib 605 days vs. erlotinib 510 days, p=0.455), and time to progression (gefitinib 186 days vs. erlotinib 262 days, p=0.660). Rashes were more common in the erlotinib group (73.3% vs. 27%, p<0.001). CONCLUSIONS: There were no significant differences in the response rate, overall survival, and time to progression between the two groups. Rashes were more common in the erlotinib group.
Adenocarcinoma ; Exanthema ; Female ; Humans ; Lung ; Lung Neoplasms ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Erlotinib Hydrochloride

BACKGROUND: The standard treatment of recurrent, symptomatic malignant pleural effusion is intrapleural instillation of a chemical agent in an attempt to achieve a sterile inflammation and pleurodesis. There are many drugs used as pleural sclerosing agents, but the efficiency and side effects are different. The present study was undertaken to compare the commonly used drugs, doxycycline and bleomycin. METHODS: Thirty-four patients with malignant pleural effusion who needed repeated thoracentesis were randomized to receive treatment with--intrapleural instillation of doxycycline or bleomycin. Fluid volumes before and after pleurodesis, drainge time, and side effects were analyzed, and the response to treatment was evaluated by clinical examination and chest radiography during admission in the hospital. Also median survival time were evaluated according to the responses. RESULTS: The response rate was higher in the patients receiving doxycycline than in those receiving bleomycin (87.5% vs 50.0%, p=0.02), and fever, nausea and vomiting were more common in the patients receiving bleomycin. The median survival time was significantly longer in the patients who responded to the sclerotherapy regardless of sclerosing agents. CONCLUSIONS: Chemical pleurodesis with doxycycline or bleomycin could reduce or stop pleural effusions and prolong the median survival times in these patients. Doxycycline appeared to be more efficient as sclerosing agent than bleomycin in the short-term follow-up periods. But a prospective study with a larger number of patients is warranted.
Bleomycin* ; Doxycycline* ; Fever ; Follow-Up Studies ; Humans ; Inflammation ; Nausea ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurodesis ; Radiography ; Sclerosing Solutions ; Sclerotherapy ; Thorax ; Vomiting

No abstract available.
Humans ; Lung*

No abstract available.
Humans ; Lung*

Microscopic polyangiitis is a systemic small-vessel vasculitis primarily associated with necrotizing glomerulonephritis and pulmonary capillaritis. This disease is determined by clinical manifestation, ANCA, and involved organ or renal biopsy. We describe a 49-year-old female presenting with chronic postnasal drip, progressive dyspnea and abrupt hemoptysis. Her serum p-ANCA was postitive, but c- ANCA was negative. Her chest X-ray and chest CT scan showed pulmonary hemorrhage, and the renal biopsy specimen revealed crescentic glomerulonephritis. She was diagnosed as having an ANCA-associated vasculitis, and more specifically, a microscopic polyangiitis accompanied with paranasal sinusitis. She was treated with intravenous methylprednisolone pulse therapy, followed by prednisolone and cyclophosphamide per oral tablets. She showed rapid progression of renal failure and died from sepsis after 2 months of treatment.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cyclophosphamide ; Dyspnea ; Female ; Glomerulonephritis ; Hemoptysis ; Hemorrhage* ; Humans ; Methylprednisolone ; Microscopic Polyangiitis* ; Middle Aged ; Prednisolone ; Renal Insufficiency ; Sepsis ; Sinusitis* ; Tablets ; Thorax ; Tomography, X-Ray Computed ; Vasculitis

BACKGROUND: There are many combinations of treatment for locally advanced non-small cell lung cancer (NSCLC). Recent studies have showed the efficacy of concurrent chemoradiotherapy (CCRT) in NSCLC. At present, however, there is no consensus about the optimal dosages and timing of radiation and chemotherapeutic agents. The aims of study were to determine the feasibility, toxicity, response rate, and survival rate in locally advanced NSCLC patients treated with doxetaxel and cisplatin based CCRT. METHOD: Sixteen patients with unresectable stage III NSCLC were evaluated from May 2000 until September 2001. Induction chemoradiotherapy consisted of 3 cycles of docetaxel (75 mg/m2/IV on day 1) and cisplatin (60 mg/m2/IV on day 1) chemotherapy every 3 weeks and concomitant hyperfractionated chest irradiation (1.15 Gy/BID, total dose of 69 Gy) in 6 weeks. Patient who had complete or partial response, and stable disease were applied consolidation chemotherapy of docetaxel and cisplatin. RESULTS: All patients showed response to CCRT. Four patients achieved complete response (25%), partial responses in 12 patients (75%). The major common toxicities were grade III or more of neutropenia (87.3%), grade III esophagitis (68.8%), pneumonia (18.8%) and grade III radiation pneumonitis (12.5%). Thirteen patients were ceased during follow-up period. Median survival time was 19.9 months (95% CI; 4.3-39.7 months). The survival rates in one, two, and three years are 68.7%, 43.7%, and 29.1%, respectively. Local recurrence was found in 11 patients (66.8%), bone metastasis in 2, and brain metastasis in 1 patient. CONCLUSION: The response rate and survival time of CCRT with docetaxel/cisplatin in locally advanced NSCLC were encouraging, but treatment related toxicities were high. Further modification of therapy seems to be warranted.
Brain ; Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy ; Cisplatin ; Consensus ; Consolidation Chemotherapy ; Drug Therapy ; Esophagitis ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Neutropenia ; Pneumonia ; Radiation Pneumonitis ; Radiotherapy* ; Recurrence ; Survival Rate ; Thorax