• Title/Summary/Keyword: 삼출

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A clinical study on the etiology of parapneumonic effusion in children (소아 감염성 흉막삼출의 원인 분석)

  • Yeom, Jung-Sook;Bae, Won-Tae;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.56-63
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    • 2006
  • Purpose : This study was designed to document the etiologies and the characteristics of parapneumonic effusion in children. Methods : During a 17-year period from 1987 to 2004, parapneumonic effusion was confirmed in 86 children at Gyeongsang National University Hospital. The clinical records of these children were reviewed and radiological findings and laboratory data, especially results of thoracentesis, were analyzed retrospectively. Results : M. pneumoniae(34 subjects) was the most common pathogen at all over age, especially above 1-years-old. There were diagnosed with clinical characteristics and serologic tests. The $2^{nd}$ most common pathogen revealed non tuberculous bacteria(14 subjects). A species of bacteria at no tuberculous bacteria revealed S. aureus(5), S. pneumoniae(3), P. aeroginosa(3), other staphylococcus (2), and K. pneumoniae(1). There were confirmed with sputum culture or pleural fluid culture or blood culture. S. aureus was most common pathogen in infants. The $3^{rd}$ common pathogen was M. tuberculosis(7). There were confirmed with skin tuberculin tests and AFB stains. Another that was classified as a non bacteria was adenovirus(2). Complications of parapneumonic effusion such as pleural thickness occurred on M. tuberculosis(1). Non tuberculous bacteria, especially S. aureus revealed a serious predominance of polymorphocyte at pleural fluid, and lowest pleural pH and glucose, and highest pleural protein and LDH. Tuberculosis revealed high pleural protein and LDH. Conclusion : Age and chemistries of pleural fluid might be helpful in differentiating various etiologies of parapneumonic effusion. If there were suspicious of tuberculosis and non-tuberculous bacteria, more aggressive approaches were needed to prevent complication.

The Cytological Study of the Experimental Middle Ear Effusion. (실험적 중이삼출액의 세포학적 고찰)

  • 심상열;문태용;윤강묵;박순일;박인용
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.13.2-14
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    • 1982
  • Otitis media with effusion, described first by Politzer (1867), is closely related with the function of auditory tube, but its etiology and pathogenesis are not clearly defined yet. There are many theories about its pathogenesis including hydrops ex vacuo theory which was most reliable nowadays. In this paper, using cats in experimental animals, hydrops ex vacuo theory was proved and cytological study of the effusion and light microscopic observation of the middle ear mucosa in otitis media with effusion were done. The results were as follows: 1) The effusion was found in all experimental groups after eighteen hours of the auditory tube obstruction. 2) In the cytological study of effusion by smear technic, Polymorpholeukocytes were dominant in earlier days but monoculear cells were soon increased and no eosinophils were found. 3) In the culture of the effusion, no bacteria was cultured. 4) By opeating microscope, hypertrophy of the middle ear mucosa observed especially in the fourteen days after auditory tube obstruction and effusion was most remarkable in the fourteen days, also. 5) By light microscopy, there were epithelial hyperplasia, proliferation of goblet cells, capillaries and infiltration of inflammatory cells which showed same distribution as smear technic.

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A Case of Pleural Effusion Associated with Acute Hepatits A (A형 간염에 동반된 흉막 삼출 1예)

  • Kim, Dong Il;Park, Jae Ock;Kim, Chang Hwi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.243-246
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    • 2005
  • Pleural effusion represents a rare complication of acute hepatitis A infection. Twelve year-old girl was admitted with complaints of general weakness, nausea and icteric sclerae. She also complained of right chest pain. Right decubitus view of chest radiograph showed pleural fluid accumulation. Laboratory findings were as follows: AST/ALT 1692/1970 IU/L, total/direct bilirubin 4.48/3.66 mg/dL and HA IgM Ab (+). On the seventh day of hospitalization, her general condition was much improved and chest radiography showed resolved pleural effusion.

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Treatment Results and Prognostic Factors of Complicated Parapneumonic Effusion and Empyema (합병부폐렴삼출 및 농흉의 치료성적과 예후인자)

  • Kim, Young-Joo;Cha, Seung-Ick;Kwon, Jee-Suk;Yoo, Seung-Soo;Jun, Hee-Jung;Kim, Eun-Jin;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.24-30
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    • 2007
  • Background: Pleural effusion develops in approximately 40% of pneumonia patients. In 5-10% of these cases, it progresses to complicated parapneumonic effusion (CPPE) or empyema that requires drainage. The prognostic factors of CPPE and empyema remain to be clarified. We examined the treatment outcomes of CPPE and empyema and elucidating their prognostic factors. Methods: One hundred and fifteen patients with CPPE or empyema, who were diagnosed and treated in Kyungpook National University Hospital (Daegu, Korea) between September 2001 and December 2005, were retrospectively analyzed. All the data was acquired from their chart review, and regarding treatment results, the time to defervescence and the length of hospital stay were analyzed. Results: The treatment was successful in 101 patients with a success rate of 87.8%. Multivariate analysis showed the level of pleural fluid lactate dehydrogenase (LDH) to be a significant prognostic factor (odds ratio [OR] 7.37; 95% confidence interval [CI], 1.63 to 33.37; p=0.009). Pussy pleural fluid (r=0.236; p=0.01) and the frequency of urokinase use (r=0.257; p=0.01) correlated with the time to defervescence. However, there was no clinical factor that correlated with the length of hospital stay. Conclusion: The pleural fluid LDH level is a useful prognostic factor for monitoring treatment results of CPPE and empyema.

An Experimental Study on Groundwater Head, Injection Water Flowrate and Seepage Water Flowrate under Clogging State of Underground Storage (LPG 지하저장기지 수평 수벽공의 클로깅 현상 발생시 지하수위 및 주입수량, 삼출수량의 변화양상에 관한 실험적 연구)

  • Han Choong-Yong;Kang Joe M.
    • Journal of the Korean Institute of Gas
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    • v.1 no.1
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    • pp.101-105
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    • 1997
  • When the water curtain system is employed to keep the liquefied gas in the underground storage cavern, clogging is observed in borehole. Since this phenomenon causes serious difficulties in managing LPG storage cavern, it needs to detect the degree of clogging accurately under various circumstances. Thus, in this study the active factors of clogging, that is, groundwater head, injection water flowrate, and seepage water flowrate, were investigated experimentally using a physical model. Experimental results show that groundwater head around storage cavern increases as cavern Pressure increases, while it decreases as clogging becomes severe. The pressure in storage cavern is required to reduce up to atmospheric pressure in order to detect and identify the degree of clogging more accurately. The decrease of uroundwater head due to clogging slows down as the pressure in borehole increases. As amounts of suspended matters in injected water increase, both injection water flowrate and seepage water flowrate decrease linearly with time, and the flowrate of injection water drops rapidly compared with seepage water flowrate.

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DYNAMICS OF GINGIVAL CREVICULAR FLUID VOLUME AND ENZYME ACTIVITIES AFTER APPLICATION OF ORTHODONTIC FORCE (교정력에 의한 치은열구 삼출액의 양 및 효소활성의 변동)

  • Kang, Ae Ree;Ryoo, Hyun Mo;Sung, Jae Hyun
    • The korean journal of orthodontics
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    • v.19 no.3
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    • pp.137-145
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    • 1989
  • The aim of this investigation was to study the effect of orthodontic force on the flow of gingival crevicular fluid and activities of arylsulfatase and brta-glucuronidase in crevicular fluid. The material consisted of 12 persons between the ages of 13 years and 22 years and all were categorized Class I, 4-4 extraction cases Crevicular fluids were sampled from distal crevis of each canine before treatment (phase 1), after bracketing (phase 2), after application of force (phase 3) and after run out of orthodontic force (phase 4). Crevicular fluid flow did not show any significant changes during the period of treatment. The activities of arylsulfatase increased significantly after setting of orthodontic appliance without application of force, but did not show any significant difference after application of force. The activities of beta-glucuronidase increased significantly after application of orthodontic force and decreased with force deminished. These indicated that beta-glucuronidase was good indicator of bone remodelling resulted from initial orthodontic force.

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Attempts to Transfer Immunity against Clonorchis in Nude and DS Mice (근교계 nude 및 DS 마우스 폐강삼출세포와 혈청의 간흡충 감염에 대한 면역이입의 시도)

  • Choe, Dong-Ik;Jeong, Dong-Il;Gang, Deok-Hui
    • Parasites, Hosts and Diseases
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    • v.29 no.4
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    • pp.371-380
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    • 1991
  • The effects of peritoneal exudate cells(PEC) and sera of athymic nude and DS mice infected with Clonorchis sinensis metacercariae or sensitized by injection of metabolic products into footpad on transfer of immunity against the fluke to the syngeneic mice were studied. There was no significant difference in eggs per gram pattern between the sensitized and control groups, and between nude and DS mice. However, the worm burdens were slightly greater in nude mice than in DS mice. Also, a few plaque forming cells were found in only DS mice given PEC and serum from Group II DS mice. In the light of these results, it is likely that PEC and sera of nude or DS mice which are deficient, at least partially, in the cellular immune system are unable to transfer immunity against C. sinensis to syngeneic recipients.

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Pleural Fluid to Serum Cholinesterase Ratio for the Differential Diagnosis of Transudates and Exsudates (여출액과 삼출액의 감별진단을 위한 흉막액과 혈청에서의 Cholinesterase 비율의 진단적 의의)

  • Cho, Ho;Kim, Hyun-Il;Eum, Min-Sup;Kwon, Han-Jin;Oh, Yong-Leul;Kim, Kwang-Suk;Kim, Hui-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.781-787
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    • 2000
  • Background : The established by Light et al in 1972 have been used widely for the differential diagnosis of the pleural effusions in transudates and exsudates. However, in recent years, several reports have agreed that these criteria misclassified an important number of effusions. For this reason, different parameters have been proposed for differentiating the transudates from exudates. Nevertheless, all these alternative parameters have not been better than the past criteria of Light et al. In response the usefulness of two parameters for differentiating pleural transudate from exudates were evaluated : pleural fluid cholinesterase level and pleural fluid to serum cholinesterase ratio. Methods : A total of forty-three patients with known causes of the pleural of the pleural effusion by diagnostic thoracentesis were studied. The following criteria for differentiating the pleural effusions in transudates and exsudates were analyzed : Ligt's criteria, the pleural fluid cholesterol level, the pleural fluid to serum cholesterol ratio, the pleural fluid cholinesterase level, and the pleural fluid to serum cholinesterase ratio. Results : The conditions of forty-three patients were diagnosed. Ten were classified as having transudates and thirty-three as exudates. The percentage of effusions misclassified by each parameter was as follows : Light's criteria, 9.3% ; pleural fluid cholesterol 2.3% ; pleural fluid to serum cholesterol, ratio, 2.3% ; pleural fluid cholinesterase, 4.7% ; and pleural fluid to serum chlinesterase ratio, 2.3%. Conclusions : The pleural fluid to serum cholinesterase ratio is one of the accurate criteria for differentiating pleural transudates from exudates. If fur1her studies confirm the results, the cholinesterase ratio could be used as the first step in the evaluation of pleural effusion and, if evaluated together with the other criteria, the differentiation of pleural transudate from exsudates will become more accurate.

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Effects of Intracavitary Urokinase Instillation in Complicated Pleural Effusion (합병성 흉막 삼출에 대한 국소적 Urokinase 주입치료 효과에 관한 연구)

  • Sohn, Dong-Hyun;Yoon, Su-Mi;Kim, Chung-Mi;Park, Ik-Soo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.357-364
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    • 2000
  • Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

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