• Title/Summary/Keyword: 호흡부전증

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Interstitial Pneumonia and Lung Cancer Surgery (간질성 폐렴과 폐암수술)

  • Sa Young-Jo;Wang Young-Pil;Park Jae-Kil
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.304-309
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    • 2006
  • Background: Interstitial pneumonia is associated with an increased risk of lung cancer but the outcome of surgical resection in this setting is unknown. The purpose of this study was to determine the relationship between pre-operative interstitial pneumonia (IP) and post-operative respiratory failure. Material and Method: A retrospective review of 672 patients with lung cancer who underwent curative pulmonary resection at the Hospital of Catholic University Medical College between 1997 and 2005 was undertaken. The patients were divided into two groups according to preexisting interstitial pneumonia and not by the pre-operative chest HRCT or findings of pathologic papers. The pre-operative data and cancer-related findings were analyzed between the IP group and non-IP group, and between the respiratory failure group and non-failure group in IP patients. Result: Twenty-eight patients (4.2%) of the developed post-operative respiratory failure and this proved to be fatal in 21 of these patients. We could find preoperative interstitial pathology in 53 patients (7.9%) among the 672 patients. The incidences of respiratory failure were 11.3% (6/53 cases) and 3.6% (22/619 cases) in IP group and non-IP group respectively, Conclusion: Interstitial pneumonia was considered one of the risk factors for developing postoperative acute respiratory failure in patients with lung cancer.

Respiratory Failure of Acute Organophosphate Insecticide Intoxication (유기인제 중독에 의한 호흡부전)

  • Shin, Kyeong-Cheol;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Chang-Jin;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.363-371
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    • 1999
  • Background: Because of the widespread use and availability of agricultural insecticides, acute organophosphate poisoning as a suicide or an accident is becoming the most common type of poisoning and serious problem in Korea. The mortality of organophosphate poisoning varied from 10 to 86 percent. The cause of death was thought to be a combination of excessive bronchial secretion, bronchospasm, respiratory muscle paralysis and depression of respiratory center, summarily respiratory failure. We evaluated the respiratory complications in patients with acute organophosphate intoxication to determine the predisposing, factors to respiratory failure and to reduce the incidence of respiratory failure or mortality. Method: We conducted a retrospective study of 111 patients with the discharge diagnosis of organophosphate poisoning who were hospitalized at Yenugnam University Hospital during the 5 years. The diagnosis of organophosphate poisoning has based on the followings (1) a history of exposure to an organophosphate compounds. (2) the characteristic clinical signs and symptoms. (3) decrease in the cholinesterase activity in the serum. Results: Respiratory failure developed in 31(28%) of 111 patients with acute organophosphate poisoning. All cases of respiratory failure developed within 96 hours after poisoning and within 24 hours in 23 patients. The 80 patients who did not develop respiratory failure survived. In 31 patients with respiratory failure, 15(44%) patients were dead. The patients with respiratory failure had more severe poisoning, that is, the lower level of serum cholinesterase activity on arrival, the higher mean dosage of atropine administered within first 24 hours. In 16 patients with pneumonia, 14 patients developed respiratory failure. In 5 patients with cardiovascular collapse, 2 patients developed respiratory failure. There was no correlation to between age, sex, the use of pralidoxime and respiratory failure. The serum cholinesterase level in survivors at time of respiratory failure and weaning was $66.05{\pm}85.48U/L$, $441{\pm}167.49U/L$, respectively. Conclusion: All the respiratory failure complications of acute organophosphate poisoning occurred during the first 96 hours after exposure. The severity of poisoning and pneumonia were the predisposing factors to respiratory failure. Aggressive treatment and prevention of the above factors will reduce the incidence of respiratory failure.

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Influence of Sleep-Related Breathing Disorders on Changes of Cardiovascular Function (수면과 관련된 호흡장애가 심혈관계의 기능 변화에 미치는 영향)

  • Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.129-139
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    • 1997
  • The data collected to date indicate that sleep-related breathing disorders, including sleep-disordered breathing(sleep apnea) and underlying respiratory system diseases, are one of the important risk factors for cardiovascular dysfunction. Sleep-disordered breathing(sleep apnea) is now recognized as one of the leading causes of systemic hypertension, cardiac arrhythmias, coronary heart disease, pulmonary hypertension, right heart failure, and stroke. Sleep may exert a profound effect on breathing in patients with underlying respiratory system disease including bronchopumonary diseases, chest wall abnormalities, central alveolar hypoventilation syndromes or respiratory neuromuscular disorders. Chronic hypoxia and hypercapnia in these patients may accelerate the development of long term cardiovascular complications such as cardiac arrhythmias, pulmonary hypertension, and right heart failure(cor pulmonale). Several recent studies reported that sleep-related breathing disorders are associated with long-term cardiovascular morbidity and mortality. Careful assessment of respiratory and cardiovascular function in these patients is critical. Aggressive and highly effective treatment of sleep-related breathing disorders using tracheostomy, mechanical ventilation, nasal continuous positive airway pressure therapy(nCPAP), intercurrent oxygen therapy or other interventions can reduce the prevalence of cardiovascular dysfunction and the long-term mortality.

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The Effect of Corticosteroid on the Diabetic-Pregnant Rats and It′s Fetus

  • Joo, Kyung-Mi;Han, Hye-Kyoung;Chung, Chun-Sik;Jung, Ki-Hwa
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.204-204
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    • 1996
  • 모체의 당뇨병은 신생아 호흡부전 증후군의 중요한 소인의 하나이며, 이것은 태아의 폐성숙이 지연되어 폐포를 안정화시키는 표면활성물질의 결여에 기인하는 것으로 알려져 있다. 폐의 표면활성물질은 지질과 소량의 단백으로 이루어진 복합물질로서 그 주성분은 phosphatidyl choline이며 동물의 종속에 관계없이 임신 말기에 그 양이 현저히 증가한다. 양수내 인지질은 주로 태아 폐에서 유래하므로 임신 말기의 양수내 lecithin/sphingomyelin(L/S)비 측정으로 태아의 호흡부전 증후군을 예측할 수 있다. 일반적으로 당뇨병 모체의 양수는 L/S비가 낮아 당뇨병 산모로 부터 출생한 신생아에서 호흡부전증의 발생빈도가 높으므로 이를 예방하기 위하여 부신피질호르몬의 투여가 고려되고 있다.

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Tricespid Regurgitation Due to Rupture of a Chordae in Newborn -A Report of One Case (신생아에서의 건삭 파열에 의한 삼첨판 폐쇄 부전 -1례 보고-)

  • 김태이;이장훈
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.927-931
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    • 1997
  • Tricuspid regurgitation due to rupture of a chorda is a rare disease in newborns. Recently, we experienced one day old male with tricuspid regurgitation due to rupture of a chorda of anterior papillary muscle, and who had suffered from severe hypoxemia, acidosis, cyanosis, and bradycardia. Preoperative diagnosis was pulmonary atresia with intact ventricular s ptum, massive tricuspid regurgitation, and patent ductus arteriosus by echocardiogram, which demonstrated no flow through the pulmonic valve. At operation, the pulmonic valve was intact and a chorda of anterior papillary muscle was ruptured. Tricuspid regurgitation was corrected successfully with reconstruction of the chords. Postoperative course was complicated by pneumonia and sepsis, but the infant recovered and discharged at postoperative 20 days.

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Clinical Efficacy of Pimobendan on Dogs with Chronic Mitral Valvular Diseases (만성 이첨판 폐쇄부전증 이환된 견에서 피모벤단의 임상적 효과)

  • Nam, So-Jeong;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.17-22
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    • 2009
  • Pimobendan is a recently developed cardiac drug which is useful to control moderate to severe congestive heart failure (CHF) from chronic mitral valvular diseases (CMVI). Because of controversy related to the efficacy and safety of pimobendan in dogs, the optimal efficacy and safety of pimobendan was assessed in 20 dogs with CMVI in this study. Scores for quality of life, respiratory failure, circulatory failure and heart failure were evaluated along with radiographical and echocardiographical assessments for about 2 months period after the addition of pimobendan into the regular cardiac medications. This study proved clear evidence that pimobendan had beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.

Amiodarone-Induced ARDS after MVR -A case report- (승모판치환술 후에 발생한 아미오다론에 의한 급성호흡곤란증훈군 -1례 보고-)

  • 이기복;김응중;지현근;신윤철
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.594-598
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    • 2002
  • Amiodarone is an iodinated benzofuran derivative that has been proved effective in the control of supraventricular and ventricular arrhythmias refractory to other antiarrhythmic drugs. In patients treated with amiodarone, subsequent surgical intervention is a common clinical scenario, but unfortunately we do not have definite data about complications due to amiodarone after cardiac surgery. Some reports have shown that amiodarone treatment can be associated with a state of $\alpha$-adrenergic and $\beta$-adrenergic receptor blockade, which requires more pacing and epinephrine infusion for perioperative hemodynamic support. And some reports have also identified a severe form of ARDS in patients on amiodarone therapy which was associated with siginificant morbidity and mortality. We exprienced a patient who expired after mitral valve replacement due to amiodarone-induced ARDS; therefore, we report this case with a brief literature.

Extracorporeal Life Support with a Twin-pulse Life Support (T-PLS) System (이중 박동성 인공심폐기(Twin-Pulse Life Support, T-PLS)를 이용한 심폐순환보조)

  • Lee, Dong-Hyup;Lee, Jang-Hoon;Jung, Tae-Eun
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.512-516
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    • 2007
  • A mechanical circulatory support system is a life-saving option for treating acute severe respiratory failure or cardiac failure. There are currently a few types of assist devices and the Twin-Pulse Life Support (T-PLS) system is a kind of pulsatile pump. We report here on three patients with severe life threatening cardiopulmonary dysfunction who had the T-PLS system used as an assist device. The indications for applying the T-PLS system were continuing respiratory or cardiac failure in spite of maximal ventilatory and inotropic support. There were two patients with acute respiratory failure due to infection and one patient with cardiac failure due to acute myocarditis. One respiratory failure patient and one cardiac failure patient survived after applying the T-PLS system for 3 days and 5 days, respectively. The T-PLS system is useful as an assist device and it should be considered before multi-organ failure occurs.

A Case of Fat Embolism Syndrome of Fat Globules Found in BAL Fluid after Recovery from Acute Respiratory Failure (급성호흡부전 호전 후 기관지폐포세척에서 지방과립구가 확인된 지방색전증후군 1예)

  • Park, Song Ree;Kim, Hyun Soo;Lee, Jae Hyung;Kim, Sang Heon;Kim, Tae Hyung;Yoon, Ho Joo;Park, Sung Soo;Shin, Dong Ho;Park, Chan Kum
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.562-566
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    • 2006
  • Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the $1^{st}$ day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.