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A Clinical Review of Broncholithiasis (기관지 결석증의 임상적 고찰)

  • Won, Jun-Hee;Cha, Seung-Ick;Park, Jun-Ku;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.677-684
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    • 1995
  • Background: Broncholithiasis is uncommon but clinically important because it may cause a variety of nonspecific symptoms and signs prior to the onset of lithoptysis, and rarely massive hemoptysis. Method: A retrospective clinical study was done on 11 case of broncholithiasis diagnosed at Kyungpook National University Hospital from Jan. 1985 to Dec. 1993. The study investigated the clinical features, radiologic findings, bronchoscopic findings and management. Results: 1) The common symptoms included cough, dyspnea, hemoptysis, fever and purulent sputum. Lithoptysis occurred in 3 patients. 2) The radiologic findings were variable and nonspecific. Hilar calcification and parenchymal calcification were the most common findings. 3) The bronchoscopy was performed in 10 patients and revealed broncholiths in 9 patients. 4) Chemical composition of broncholiths was analyzed in 2 patients. Calcium carbonate was main component. 5) In 6 out of 9 patients in whom broncholiths was revealed by bronchoscopy, broncholiths were successfully extracted through the flexible bronchoscope. 6) In 9 patients, broncholithiasis was related to tuberculosis and in 1 case, related to silicosis. Conclusion: Broncholithiasis shows a variable clinical spectrum. Tuberculosis is the most common cause of broncholithiasis. In the case of no accompanied complication, nonsurgical management such as bronchoscopic removal and conservative therapy is an effective measure.

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Measurement of the Device Properties of a Ionization Smoke Detector to Improve Predictive Performance of the Fire Modeling (화재모델링 예측성능 개선을 위한 이온화식 연기감지기의 장치물성 측정)

  • Kim, Kyung-Hwa;Hwang, Cheol-Hong
    • Fire Science and Engineering
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    • v.27 no.4
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    • pp.27-34
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    • 2013
  • The high prediction performance of fire detector models is essentially needed to assure the reliability of fire and evacuation modeling in the process of PBD (Performance Based fire safety Design). The main objective of the present study is to measure input information in order to predict the accurate activation time of smoke detector into a Large Eddy Simulation (LES) fire model such as FDS (Fire Dynamics Simulator). To end this, FDE (Fire Detector Evaluator) which can measure the device properties of detector was developed, and the input information of Heskestad and Cleary's models was measured for a ionization smoke detector. In addition, the activation times of smoke detectors predicted using default values into FDS and measured values in the present study were systematically compared. As a result, the device properties of smoke detector examined in the present study showed a significant difference compared to the default values used into FDS, which resulted in the considerable difference of up to 15 minutes or more in terms of the activation time of smoke detector. The database (DB) on device properties of various smoke and heat detectors will be built to improve the reliability of PBD in future studies.

Role of the Baseline Heart Rate Variability to the Effect of the Huanglian-Jie-Du Granule in Hwa-Byung Patients: Supplementary Analysis from the Randomized Trial Comparing Huanglian-Jie-Du Granule and Placebo for Hwa-Byung (화병 환자의 심박변이도 차이에 따른 황련해독탕의 효과: 화병에 대한 무작위 대조 비교임상시험 결과의 추가 분석)

  • Choi, Yu-Jin;Cho, Seung-Hun
    • Stress
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    • v.26 no.4
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    • pp.305-311
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    • 2018
  • Background: The purpose of the study was to explore whether the effect of Huanglian-jie-du granule depends on the baseline heart rate variability in patients with Hwa-byung. Methods: We used the supplementary data from a randomized, double-blind, placebo-controlled trial of Huanglian-jie-du granule for Hwa-byung patients. Study drugs were taken orally three times per day for one week. Heart rate variability was measured three times; before the treatment, after the treatment, and month follow-up period. Spearman's rho test was done to explore the role of the baseline heart rate variability to the effect of Huanglian-jie-du granule. Results: Baseline low frequency power of heart rate variability was negatively correlated with the reduction of the insomnia severity index in experimental group (r=-0.493 p=0.02). Also, Huanglian-jie-de granule significantly decreased the low frequency power of heart rate variability in patients with Hwa-byung compared to placebo (mean difference 266 [95% CI: 29~503], p=0.028). In Hwa-byung symptoms, stuffy, pushing up in the chest, and flush of anger were correlated with low frequency power of heart rate variability (p=0.010, p=0.000, and p=0.016, respectively). Conclusions: The effect of the Huanglian-jie-de granule for insomnia seems to be lower when the baseline low frequency power of heart rate variability is higher in Hwa-byung patients. Also, Huanglian-jie-de granule is likely to decrease the sympathetic activity in patients with Hwa-byung. Measurement of heart rate variability may be the useful to understand the state of Hwa-byung patients.

The First Neonatal Case of Panton-Valentine Leukocidin-Positive Staphylococcus aureus Causing Severe Soft Tissue Infection in Korea

  • You Hoon Kim;Seung Hyun Shin;Hyeri Seok;Dae Won Park;Young Hwan Park;Yoonsun Yoon;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.152-158
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    • 2023
  • Staphylococcus aureus (SA) is a common cause of skin and soft tissue infections. Panton-Valentine leukocidin (PVL) toxin-producing strain of SA has been discovered worldwide and is known to cause serious infections. However, reports of neonatal infections caused by PVL-positive SA are rare. Here, we report a case of severe skin and soft tissue infection caused by PVL-positive SA in a 7-day-old neonate. The patient was admitted to the emergency room with a history of fever for one day, tenderness, and sensation of buttocks heating. The infant presented with fever, tachycardia, poor general health, progressive tenderness, and edema of the buttocks on the day of admission. Ultrasonography and magnetic resonance imaging revealed necrotizing fasciitis involving the skin, soft tissue, and muscles. Specimens drained from the buttock lesions confirmed the presence of PVL-positive methicillin-resistant SA (MRSA), and there was no bacteremia. She recovered after one month of intravenous antibiotics and surgical drainages. One month after discharge, she was rehospitalized for otitis externa and was infected with MRSA again. Considering the PVL-positive strain, the patient was treated with intravenous linezolid and dressing. The patient underwent decolonization therapy in a 0.5% chlorhexidine bath and recovered completely without sequelae. This case suggests that aggressive drainage and antibiotic treatment are essential for PVL-producing MRSA infections, and additional decolonization is needed to prevent recurrence and community spread.

Clinical features of human metapneumovirus infection in children with acute respiratory tract infections (급성 호흡기 감염증 소아에서 Human metapneumovirus 감염의 임상 양상)

  • Lee, Jae Sook;Seo, Hyun Joo;Woo, Jeong Ju;Jang, Sung Hee;Lee, Jin A;Song, Mi Ok;Park, Hwa Young;Ahn, Young Min
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.75-82
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    • 2007
  • Purpose : Human metapneumovirus (hMPV) is a newly identified paramyxovirus that causes a variety of clinical syndromes in children, including upper and lower respiratory tract illnesses. hMPV is considered an ubiquitous virus causing respiratory tract diseases among children especially during late winter and spring seasons. We report clinical features of human metapneumovirus infection in Korean children. Methods : hMPV infection was diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR) in respiratory specimens obtained from patients with acute respiratory tract infections from October, 2004 to May, 2005. Medical records of all hMPV-positive patients were reviewed, retrospectively. Results : A total of 15 hMPV were identified from 443 nasopharyngeal aspirations by RT-PCR (3.4%). The range of age of the patients with hMPV infection was from 1 month to 62 months (median age, 31.5 months), with similar numbers of females (8/15) and males (7/15). Among hMPV-positive children, 53.3% (8/15) were aged less than 24 months. Fever, cough, rhinorrhea, vomiting, diarrhea, tachypnea, and chest wall retractions were common findings. Most common clinical diagnosis was pneumonia (60%). Two of the 15 hMPV-positive patients were also positive for adenovirus. Fever persisted from 0 to 10 days (mean 4.9 days). The duration of hospitalization ranged from 4 to 7 days (mean 5.6 days). Conclusion : hMPV accounted for a small but significant proportion of respiratory tract infection in infants and children. Future development and application of diagnostic tools will determine the burden of disease caused by this newly discovered pathogen.

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The Clinical Aspects of Acute Septic Arthritis and Acute Osteomyelitis in Children (소아기 급성 화농성 관절염과 급성 골수염의 임상적 고찰)

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.149-156
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    • 2005
  • Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

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Effect of Quercus acutissima CARRUTHERS Extracts on the Lipid Metabolism (도토리추출물이 흰쥐의 체내 지질대사에 미치는 영향)

  • Sung, In-Suk;Kim, Myung-Joo;Cho, Soo-Yeul
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.26 no.2
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    • pp.327-333
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    • 1997
  • This study was conducted to investigate the effect of Quercus acutissima CARRUTHERS extracts on lipid metabolism. Sprague-Dawley male rats$(110{\pm}10g)$ were fed on containing normal and high fat diets. They were orally administrated(0.02g/100g B.W.) of Quercus aculissima CARRUTHERS ethylacetate-extract and water-extract at the same time once a day respectively. The rats were sacrificed after 6 weeks of feeding periods. In high fat diet group, liver and heart weight were increased but kidney weight was decreased. Contents of total lipid, triglyceride and phospholipid were increased in high fat diet groups. But the degree of increment was reduced by administration of Quercus acutissima CARRUTHERS extracts and water extract was more effective. Significant decrease in serum total lipid content by administration Quercus acutissima CARRUTHERS extracts was not due to decrease of triglyceride content but total cholesterol content. Whereas HDL-cholesterol content was significantly decreased in high fat diet group and improved by administration of Quercus acutissima CARRUTHERS extracts. Total lipid, triglyceride and total cholesterol contents in liver were also increased in high fat diet group but phospholipid content was significantly decreased. The results indicate that Quercus acutissima CARRUTHERS extracts were effective in preventing hyperlipidemia and water extract was more effective.

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Predictive value of cobalt chloride solution for hypohidrosis with topiramate (약물 유발 소한증에서 cobalt chloride solution의 임상적 유용성)

  • Lee, Hyuk;Lee, Seung Hyun;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1180-1185
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    • 2006
  • Purpose : The aims of this study were to verify the incidence of hypohidrosis and to determine the predictive value of noninvasive indicator test ($Neurocheck^{TM}$) for sweating after administration of topiramate in newly diagnosed pediatric epileptic patients. Methods : A total of 46 epileptic patients (22 boys; 24 girls) on topiramate treatment were evaluated in this study at the Department of Pediatrics, Chonbuk National University Hospital, from October 2004 to July 2005. We measured sweating functions using a noninvasive sweating test ($Neurocheck^{TM}$) before topiramate medication, and after 3 months when topiramate reached its target dosage. We performed a direct questionnaire survey for the hypohidrosis related symptoms during topiramate treatment. Results : The mean age was $7.8{\pm}3.2year$. The mean dosage of topiramate was $4.5{\pm}0.8mg/kg/day$. Among the patients, there were 40 complex partial seizures, one simple partial seizure, two partial seizures with secondarily generalization, two generalized seizures, and one Lennox-Gastaut syndrome case. Of the 46 epileptic patients, 17 patients (37.0 percent) experienced hypohidrosis and hypohidrosis related symptoms, 12 (26.1 percent) had facial flushing, four (8.7 percent) had heat intolerance, one (2.2 percent) had lethargy, but no one had anhidrosis. Among the 17 patients, the mild group numbered 12 and the severe group totalled five. Hypohidrosis by $Neurocheck^{TM}$ was diagnosed in 16 patients. The overall measures of agreement between $Neurocheck^{TM}$ and the survey was 76.5 percent. The specificity of this test was 89.7 percent. Patients who showed a time delay after medication, especially over 3 minutes, were seen only in the severe group. Conclusion : $Neurocheck^{TM}$ could be clinically useful to detect and predict topiramate induced hypohidrosis in pediatric epileptic patients. We recommend that patients who show a delay over 3 minutes in $Neurocheck^{TM}$ test after topiramate initiation should be monitored for hypohydrosis.

Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.

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Efficacious Pleurodesis with OK-432 Plus Autoblood or OK-432 Against the Pneumothorax with Persistent Air Leak (지속성 기흉에서 OK-432와 자가혈액을 이용한 흉막 유착술의 효과)

  • Kim, Hyoung Soo;Choi, Goang Min
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.72-75
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    • 2006
  • Background : This report reviews our experience with persistent air leaks in the peumothorax that were not considered candidates for surgical treatment in order to evaluate the efficacy and risks of the OK-432 plus autoblood or OK-432 pleurodesis. Material & Methods : From March 2004 to July 2005, 8 consecutive patients who had an air leak in the pneumothorax over 5 days and had been treated with OK-432 plus autoblood or OK-432 pleurodesis. The patients were not considered candidates for surgical treatments because the chest CT findings revealed severe chronic lung disease with multiple bullae and/or bullous changes. A prolonged air leak with/without dead space was treated with either OK-432 plus autoblood or OK-432 pleurodesis. The efficacy and side effects of OK-432 pleurodesis were assessed by determining the duration of the air leak, the number of pleurodesis, the patients' symptoms, measurements of the white blood cell count and the c-reactive protein level. Results : All of eight patients were male and the mean age was $72.4{\pm}8.5$. The mean number of pleurodesis was $1.9{\pm}1.1$ and the mean duration of the air leak was $4.6{\pm}4.6days$ after pleurodesis. Side effects after pleurodesis were encountered in 7 patients, which included a chilling sensation in 7 cases, chest pain in 5 cases, headache in 3 cases, local heat sensation in 2 cases, and fever in 1 case. Leukocytosis was observed in 6 patients, and the mean of WBC count and CRP were $14500{\pm}2100$ and $21.9{\pm}11.4mg/dL$, respectively. Conclusion : Either OK-432 plus autoblood or OK-432 pleurodesis has acceptable side effects, and can be considered a treatment option for persistent air leaks in the pneumothorax that are not candidates for surgical treatment.