• Title/Summary/Keyword: 호흡 일

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Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후)

  • Han, Min Soo;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yongseon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.445-450
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    • 2008
  • Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

Toxic Effects of Phenol on Survival and Oxygen Consumption of the Abalone Juvenile, Haliotis discus hannai (참전복, Haliotis discus hannai 치패의 생존과 산소소비에 미치는 phenol의 독성 영향)

  • KIM Heung-Yun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.30 no.3
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    • pp.496-504
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    • 1997
  • This study was carried out to estimate toxic effects of phenol on survival and metabolism of the abalone juvenile, Haliotis discus hannai. The experiment was conducted by renewal bioassay procedure with different salinities at $20^{\circ}C$. The $LC_{50}$ of the juvenile exposed to phenol in the range of 0.5 and $100mg/\ell\;was\;34.3\~6.5mg/\ell\;at\;2.4\%_{\circ}\;and\;52.2\~9.3m/\ell\;at\;32\%_{\circ}$ salinity with exposure time from 24 hours to 96 hours. $LT_{50}$ was remarkablely reduced with increase of phenol conentration and decrease of salinity. Lethal toxicity or phenol was higher at low salinity than at high salinity. Therefore, salinity is likely to be one of factor to increase phenol toxicity. The oxygen consumption of the juvenile was reduced with increase of phenol concentration and with decrease of salinity. In spite of phenol toxicity, the oxygen consumption of the juvenile exposed to phenol of low concentration was high and similar as compared with that of control group. Survival rates of the abalone kept in phenol-free sea water after exposure to phenol concentration of 5, 10 and $20mg/\ell$ for 96 hours were reduced with decrease of salinity. Durations required to recover the normal metabolic rate of the juvenile, which was exposed to phenol concentration of 5, 10 and $20mg/\ell$ for 96 hours, were made longer with increasing phenol concentration. In the case of the juvenile exposed to sublethal concentration of phenol for 15 days, it were elongated as compared with that of the abalone exposed to phenol concentration caused acute toxicity. The result of this experiment indicated that relatively low concentration of phenol can impact on the abalone juvenile in marine ecosystem.

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Anthelmintic Efficacy of Tetramisole Against Experimental Infection of Swine Lungworm, Metastrongylus Apri (Tetramisole에 의한 돈폐충(豚肺蟲)(Metastrongylus apri) 구충(驅蟲) 효과(效果)에 대(對)하여)

  • Lee, Byung Do;Kim, Chin Bok
    • Korean Journal of Veterinary Research
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    • v.8 no.1
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    • pp.11-17
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    • 1968
  • Oral and subcutaneous administration of Tetramisole (d1-2, 3, 5, 6-tetrahydro-6-phenyl-imidazo- 2, 1-b thiazole hydrochloride) was effective in controlling the adult and immature forms of Metastrongylus apri in pigs when administered at the dose of 10-12.5 mg per kg of body weight.

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Disseminated Cryptococcosis in a dog due to Cryptococcus neoformans var. neoformans (한 마리의 개에 있어서 Cryptococcus neoformans var. neoformans에 의한 파종성 크림토콕스병)

  • 팔마헨드라;마쭈자카나오노리;이창우
    • Journal of Veterinary Clinics
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    • v.13 no.2
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    • pp.198-203
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    • 1996
  • 일반적인 치료에 반응을 나타내지 않는 호흡곤란증에 걸린 4년령의 Shepherd개에서 피부, 눈, 림프절의 병변을 동반한 치명적인 파종성 크립토콕스병이 진단되었다. 세포학적검사에 의해 난원형 내지 구형이고, 두꺼운 협막을 갖고 있는, 형태학적으로 Cryptococcus neoformans와 일치하는 효모균이 증명되었다. 이 병원체는 혈액, 오줌, 콧물, 견갑전림프절 흡인물, 피부생검 시료, 피부 면봉 시료 등을 25$\circ $C의 Pal씨 배지에 접종하여 용이하게 분리되었다 배양물을 PHOL염색액으로 염색하여 현미경으로 검사한 결과 얇은 막에 싸인 발아를 나타내거나. 나타내지 않는 구형 내지 난원형의 효모균이 증명되었다. 이 개는 ketaconazole 로 치료를 시작 한 후 6일만에 폐사하였다. 공기, 흙, 비둘기 배설물, 톱밥 등을 Pal씨 배지에 접종하여 C.neoformans가 배양됨으로써 역학적으로 환경이 병원소 역할을 한 것으로 판단되었다. 환축과 환경으로부터 분리된 균주는 세밀한 동정결과 neoformans (serotype AD)에 속하며, Filobasidiella neoformans "alpha" mating type을 나타내었다. 이 연구결과, Pal씨 배지가 크립토콕스병의 조기진단과 역학적 조사에 훌륭한 감별배지라는 것이 입증되었다. 개량된 Pal씨 배지는 C. neoformans의 genetic crossing을 판단하는데 성공적으로 사용할 수 있었다.

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칼슘차단제의 시판후 조사

  • 김영식;조홍준;최현림;서홍관;신호철;김경수;양윤준;김영주;조경환
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.195-195
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    • 1994
  • 병원별 총 추적기간은 602-4,137 인년 이었으며, 병원별 대상자 1인당 추적일수의 중앙값은 34.5-61일 이었다. 병원별 추적 완료율도 35.3-92.3%로 다양하게 나타났다. 대상자중 칼슘차단제의 혈관확장효과에 따른 부작용들의 8주간 누적 발생율을 보면, 안면홍조 23.3%, 두통 13.5%, 심계항진 13.3%, 어지러움 7.6%, 하지부종 6.6% 였다. 그 외 부작용으로는 변비 13예, 소화장애 8예, 오심 6예, 치은비대, 안면부종, 피로감이 각각 2예, 탈모증, 불면증, 허약감, 피부질환, 호흡곤란, 손발저림, 발한, 구강건조 등이 각각 1예 있었다. 안면홍조의 발생율이 남자(12.9%)보다 여자(29.9%)에서 높았으며, 투여한 약제에 따라서 Nitrendipine 34.0%, Nifedipine 26,6%, Nicardipine 17.8%, Amlodipine 12.2%로써 약제별로 차이가 있었다. 두통의 발생율은 40세 미만 32.8%, 40-54세 15,8%, 55세 이상 10.5%로써 연령이 증가할수록 발생율이 낮았다. 하지부종의 발생율도 남자(3.4%)보다 여자(8.6%)에서 높았으며, 투여한 약제에 따라서 Nitrendipine 15.2%, Nifedipine 10.0%, Amlodipine 2, 1%, Nicardipine 0%로써 약제별로 차이가 있었다. 안면홍조가 발생한 환자에서 약물을 계속 투여시 2주후에 63.5%, 4주후에 77.0% 6주후에 88.5%가 소실하여 최초 안면홍조가 발생한 환자중 11.5%에서만 증상이 남아있었다. 약물투여를 중단하게 된 사유는 안면홍조와 두통이 각각 15예, 심계항진 4예, 어지러움 2예, 변비 및 안면부종이 각각 1예로 나타났다.

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Tracheomalacia Associated with Esophageal Atresia - A case report - (식도폐쇄증과 동반된 기관연화증 - 1예 보고 -)

  • Song Seung-Hwan;Chang Yun-Hee;Lee Chang-Hun;Shin Dong-Hoon;Sung Si-Chan
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.643-647
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    • 2006
  • Congenital tracheomalacia associated esophageal atresia is a rare foregut anomaly. We report a case of 40-day old male infant with tracheomalacia who has undergone repair of esophageal atresia at his age of 1 day. The patient had progressive dyspnea and stridor after repair of esophageal atresia. His 3-dimensional chest computed tomography showed severe stenosis at the middle of trachea. We underwent resection and end-to-end anastomosis under cardiopulmonary bypass. Histologic examination revealed esophageal tissues indicating congenital origin as well as no cartilage.

Surgical Correction of Total Anomalous Pulmonary Venous Return (총폐정맥 환류이상증의 외과적 치료)

  • 금동윤;이광숙
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.292-296
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    • 1996
  • Total anomalous pulmonary venous return is a rare but serious cardiac malformation, accounting for only about 1.5~3% of congenital heart disease. Surgical results have been dramatically improved in the last two decades, largely owing to improved techniques of cardiopulmonary bypass and perloperative management. Seven patients ranging in age from 15 days to 11 years with total anomalous pulmonary venous return underwent repair between 1984 and 1995. The types of anomalous return were supracardiac in 5, and cardiac in 2. There were 5 boys and 2 girls. There were two hospital death, occurred in 15-day-old, and 40-day-old infants with supracardiac type. Follow-up periods have ranged from 3 months to 11 years, and all survivors have remained asymptomatic with normal growth and development.

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바이러스 백신의 전망

  • 김경호
    • The Microorganisms and Industry
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    • v.10 no.1
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    • pp.2-6
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    • 1978
  • 백신이란 학문의 원조는 고금 동서를 불문하고 영국의 Jenner라는 것은 우리가 잘아는 사실이다. 이것은 약 200년전의 일이며 그후 각종 전염병예방 백신이 개발되어 오늘날 우리인간은 예전ㅇ 비해 각종 전염병에 대해 큰 은혜를 받고 있는 셈이다.특히 1949년 미국의 Enders박사 일맥의 조직 배양의 개량법에 의한 바이러스의 대량 배양과 정제및 농축이 용이하게 된것은 백신생산 개발문제뿐만아니라 바이러스학과 전염병 예방학의 발전의 일대혁신을 가져왔으며 세균학에 있어서 Koch의 고형배제를 사용하여 많은 병원성세균의 발견을 하게된 것과 비슷한 느낌을 준다. Enders의 조직배양의 modern technique는 아직까지 원인불명인 여러 종류의 바이러스 전염병 병원체가 구명되었으며 지금도 계속 새로운 바이러스가 발견되고 있는 중이다. 그 대표적인 예를 들면 폴리오(Polio)를 중심으로 Coxsackie virus의 A및 B군과 ECHO virus등 장관계바이러스들의 발견과 그 체계적정비 그리고 Adeno virus를 위시한 호흡기계 바이러스들의 계속적인 발견과 그 실험실진단법의 확립등을 들수 있다. 한편 백신개발에 대한 확립 등을 들수있다. 한편 백신개발에 대한 발자취를 보면 폴리오를 위시하여 홍역(Measles)백신, 멈프스(Mumps)및 풍진 (Rubella virus) 백신등의 개발은 근래 선,후진국을 막론하고 이러한 전염병의 예방효과가 눈에 띠게 덕을 보고있는 것이다. 지금 세계적으로 많은 전염병의 병원체가 바이러스라는 것이 알려져 있고 또한 이에 대한 백신의 개발연구가 활발하게 진행되고 있다. 이번 기회에 바이러스백신의 전망이라는 제목을 가지고 논하게 된것을 기쁘게 생가하며 동시에 어려운 과제라고도 생각된다. 왜냐하면 아직 우리나라에서는 생산을 못하고 있는것이 많은데 그 전망을 말하기가 어려운 까닭이며 또한 제한된 지면에서 충분히 고찰하기는 어렵다. 우리나라에서 자주 거론되는 백신 및 종류에 국한하여 그 문제점과 앞으로의 전망을 고찰해 보기로 한다.

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Right Single Lung Transplantation in Pulmonary Emphysema Patient - A report of case - (폐기종환자에서의 우측 폐이식술 -1 례보고 -)

  • 신화균;김해균;이두연;백효채;홍윤주;황정주;김부연;류송현
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.585-589
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    • 2000
  • Lung transplantation has been successfully employed for variety of obstructive lung disease. Single lung transplantation has become a therapeutic option for end-stage obstructive lung disease. The patient, a 57 year old man with emphysema, suffered from severe dyspnea, which progressively aggravated him for the last three years. A single lung transplantation was performed from a young brain-dead donor on April 7th, 1999 in the department of thoracic surgery, Respiratory Center, Yongdong Severance hospital, yonsei University. The immunosuppressive regimen was based on cyclosporine A and azathioprine from beginning, adding steroid. Single lung transplantation was feasible and beneficial in patients with end-stage emphysema.

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Intractable Hemoptysis due to Valvular Heart Disease Treated by Emergency Redo DVR: 1 case report (판막부전증에 의한 대량객혈의 응급 이중판막 재치환술: 1례 보고)

  • 이재훈;전양빈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.423-427
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    • 1997
  • Hemoptysis occurs quite frequently as a consequence of mitral stenosis, but massive, lirE threatening pulmonary hemorrhage is distinctly unusual. We report a 30 year old female who underwent cmcrgcncy rcdo double valve replacement for intractable pulmonary hemorrhage. she underwent mitral valve replacement (lonescu Shirley 27 mm) due to rheumatic valvular heart disease in 1984 and tricuspid valve annuloplasty (Carpentier's rlng 30mm) two years later She was admitted for massive hcmoptysis and dyspnea on the 26th of December, 1995. Medical treatment including transarterial embolization was given but was not satisfactory. Emergency valve replacement (Mitral valve , 51. Judc 29mm and tricuspid valve ; 51. Jude 33mm) was performed and hemoptysis was controlled dramatically 24 hours after surgery.

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