• 제목/요약/키워드: Bronchiolitis

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A Case of Cavitary Lung Lesion as a Consequence of Smoke Inhalation Injury (흡입화상 치료과정에서 생긴 공동성 폐 병변)

  • Shin, Hyun Won;Kim, Cheol Hong;Eom, Kwang Seok;Park, Yong Bum;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Eil Seong
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.564-570
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    • 2006
  • Toxic gases and soot deposition as a consequence of smoke inhalation can cause direct injury to the upper and lower airways and even to the lung parenchyma. A delay in proper and prompt therapy can be detrimental to critically ill burn patients with an inhalation injury. Therefore, serial chest radiography is an important diagnostic tool for pulmonary complications during treatment. The radiographic findings of the chest include normal, consolidation, interstitial and alveolar infiltrates, peribronchial thickening, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, and a pneumothorax as acute complications of smoke inhalation. In addition, bronchiectasis, bronchiolitis obliterans and pulmonary fibrosis can occur as late complications. We encountered a case of 44-year-old male who presented with acute lung injury after an inhalation injury. He required endotracheal intubation and mechanical ventilation due to respiratory failure. He was managed successfully with conservative treatment. Later, a cavitary lesion of the left upper lobe was observed on the chest radiography and computed tomography, which was complicated by massive hemoptysis during the follow-up. However, the cavitary lesion disappeared spontaneously without any clinical consequences.

The Clinical Study of Biyun(sinusitis) in Children (소아비연(小兒鼻淵)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Park Eun-Jeong;Lee Hae-Ja
    • The Journal of Pediatrics of Korean Medicine
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    • v.12 no.1
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    • pp.111-131
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    • 1998
  • 1. In oriental medicine, the case of sinusitis can be explained, not only external invasion such as PUNG HAN(wind-cold), PUNG YUL(wind-hot), SHUP YUL(damp-heat), but also functional disorder of internal organ such as spleen(脾), lung(肺), kidney(腎) The western medicine classified the cause of sinusitis as two factors. That is bacterial infection factor-Haemophilus influenza, streptococcus pyogeues, streptococcus pneumonia- and viral infection factor-Rhinovirus, parainfluenza, Echo28, Coxsacki21, Sinusitis is complicated to allergic rhinitis, chronic otitis media purulent, chronic tonsilitis, sinubronchitis. On the condition of nasal septum deformity, turbinates deformity, nasal septum deviation, sinusitis can be developed. the predisposing factors of sinusitis is swimming, air pollution, malnutrition, shortage of immunity.2. According to survey, sinusitis occurred that children from 4 to 12 years old and from 5 to 7 years old occupied 70% 3. From the past history data, they experienced chronic tonsillar hypertropy(20%), otitis media, atopic dermatitis, allergic rhinitis, bronchial asthma, pneumonia, bronchiolitis, chronic sore throat, urticaria, milk allergy in sequence. 4. the symptoms of sinusitis is nasal obstruction, postnasal dripping, purulunt(yellow)or white discharge, cough, nose bleeding in sequence. nasal obstruction take the portion of 95%, postnasal dripping 65%, night time or early morning cough 60%. 5. The suffering period of sinusitis is 6 month minimum, 4 years maximum, most cases are included in a year. The suffering period of children was shorter than adult. 6. Diagnosis depend on inspection of nasal cavity, postnasal dripping, X-ray finding. 75% of patient(15case) showed both maxillary sinusitis, 25%(5cases) showed left or right maxillary sinusitis. 7. Treatment of oriental medicine, consist of Herb-medicine, acupuncture and exposing of Lazer beam. Kamihyunggyeyungyotang(加味荊芥蓮翹湯) is administered mainly as the medical therapy, Kamigwaghyangjeungkisan(加味藿香正氣散) Kimizwakwieum(加味左歸飮), Kamihyangsosan(加味香蘇散) is administered for a additional symptoms which occurred by influenza recurrence. Kamijeonxibackchulsan(加味錢氏白朮散) is administered to treat gastro-intestine trouble patients who have sinusitis. 8. The period of treatment is varied with patient conditions and X-ray finding. The minimal period is 35days, maximal period is 202days. So it took about 86days in average and about 50% of patient(10cases) is recovered in one or two month.

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Viral Etiology and Clinical Pattern of Acute Lower Respiratory Tract Infection in Children(Busan Area in 2002) (소아 급성 하기도 감염의 바이러스 원인 및 임상 양상 (2002년 부산 지역))

  • Lee, Na Young;Park, Ji Hyun;Kim, Gil Hyun;Jung, Jin Hwa;Cho, Kyung Soon;Kim, Sung Mi
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.87-94
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    • 2003
  • Purpose : Respiratory viruses are one of the most infectious agent in human. Acute lower respiratory tract infection(ALRTIs) is associated with significant morbidity and mortality in children. This study is performed to investigate the etiologic organism, age and sex distribution, clinical manifestations and seasonal occurrence of ALRTIs in children. Methods : Viral agent was evaluated with nasopharyngeal aspirates, rhinorrhea and saliva collected from 568 patients. We confirmed viral agents in 54 patients who were younger than 15 year old. They had visited Maryknoll Hospital, Busan in Korea from January, 2002 to December, 2002 for ALRTIs. Results : The viral pathogens identified were Influenza A virus(59.3%), Enterovirus(33.3%), Adenovirus(5.6%), and Influenza B virus(1.9%). Parainfluenza virus and Respiratory syncytial virus were not detected. The occurrence of acute lower respiratory infections was high between 3 & 6 years old. The clinical patterns include pneumonia(51.9%), bronchitis(31.5%), croup(9.3%), bronchiolitis(7.4%). The respiratory viral agents had their characteristic seasonal patterns. Conclusion : Influenza A virus was the most common cause of acute lower respiratory tract infections in Busan area during the 2002. ALRTIs had high occurrence between 3 to 6 years old. And the most common clinical patterns were pneumonia and bronchitis.

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Epidemiologic Characteristics of Human Bocavirus-Associated Respiratory Infection in Children (소아 보카바이러스 호흡기 감염증의 역학적 특징)

  • Choi, Jae Hong;Paik, Ji Yeun;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.61-67
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    • 2011
  • Purpose : This study was performed to investigate the epidemiologic characteristics of human bocavirus (HBoV)-associated lower respiratory tract infections (LRTIs) in children. Methods : Nasopharyngeal aspirate samples were obtained from 658 children who had been hospitalized for LRTIs in Seoul National University (SNU) Children's Hospital and SNU Bundang Hospital from March 2000 to September 2005. Multiplex RT-PCR was performed to detect 11 respiratory viruses including respiratory syncytial virus, adenovirus, rhinovirus, parainfluenza viruses 1 and 3, influenza viruses A and B, human metapneumovirus, HBoV, human coronavirus (HCoV) OC43/ 229E, and HCoV-NL63. Clinical data were reviewed retrospectively. Results : Overall, respiratory viruses were detected in 325 (49.4%) among 658 patients. HBoV was detected in 62 cases (9.4%) and was responsible for 19.1% of virus-positive cases. HBoV was prevalent among infants and young children aged from 3 months to 5 years with the mean age of 25.3 months. Co-detection of HBoV and other respiratory viruses was observed in 37.1% which is significantly higher than average co-detection rate (12.3%) among overall virus-positive cases (P=0.000). HBoV was identified mainly in late spring and early summer from May to July. Conclusion : This study describes epidemiologic features of HBoV in Korean children compared with those associated with other respiratory viruses. HBoV was prevalent among LRTIs in childhood, especially in late spring and early summer season in Korea.

The Clinical Observations in Childhood Asthma (기관지 천식의 초기 발병시 임상적 양상에 관한 관찰)

  • Song, Kih-Yean;Park, Yong-Hyoun;Jun, Jin-Gon;Lee, Young-Hwan;Kim, Chun-Dong
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.239-247
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    • 1992
  • A clinical analysis was done on 134 cases with bronchial asthma who were admitted to the Department of Pediatrics Yeungnam University from May 1987 to October 1991. The results were as followings; 1) The peak age of bronchial asthma was under 2 years. The sex ratio of male to female was 2.9 : 1. 2) The out-break of bronchial asthma was most common in fall, especially in September. 3) The past history of other allergic diseases were present in 22.4% of patients(30/134 cases), and the previous bronchiolitis in infancy were experienced in 12.7% of patients(17/134 cases). 4) According to the skin test for allergens done by RAST, the most common allergens were Mites and House dust. 5) Eosinophilia(T.E.C>250/min) was found in 29.1% of patients, and elevated IgE level(>200 $IU/m{\ell}$) was found in 63.2% of patients. 6) No significant differences in the serum IgE level were found between male and female patients. No significant differences in the serum IgE level were found between asthma patients with and without other allergic diseases. 7) The serum IgE level of school aged patients was significant higher than that of preschool aged(p<0.01).

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Evaluation of Antimicrobial, Antithrombin, and Antioxidant Activity of Fritillaria thunbergii Miquel (패모(Fritillaria thunbergii Miquel)의 항균,항혈전 및 항산화 활성 평가)

  • Shin, Yong-Kyu;Jang, Han-Su;Kim, Jee-In;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.19 no.9
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    • pp.1245-1250
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    • 2009
  • Beimu (Fritillaria thunbergii Miquel), a bulbous plant of Liliaceae found in Korea, Japan and China, has been used as an antitussive and expectorant agent, and is also useful in alleviating stonsillitis and bronchiolitis. Most researches have been focused on micro-propagation and plant regeneration, component analysis, and dormancy relieving of beimu. Reports regarding the biological activity of beimu, such as anti-Helicobacter pyroli or platelet aggregation inhibition activity, are few and not widely available. In this study, methanol extract and its organic solvent fractions were prepared from Fritillaria thunbergii Miquel and their antimicrobial, antithrombin, and antioxidant activities were evaluated, respectively. The methanol extract contained lots of water-soluble materials (58.98%) and hexane-soluble oils (14.85%). The ethylacetate and butanol fraction at $500{\mu}g$/disc concentration showed strong antibacterial activity against tested bacteria, except Escherichia coli. Antifungal activity was not observed in methanol extract and its fractions. The hexane, ethylacetate and butanol fractions showed strong antithrombin activity at 4.8 mg/ml concentration. Especially, the ethylacetate fraction showed 95.4 sec of thrombin time at a concentration of 1.2 mg/ml, which is comparable to aspirin, a widely used antithrombosis agent. For antioxidation activity, the ethylacetate and butanol fraction showed good 1,1-diphenyl-2-picryl hydrazyl scavenging activity ($IC_{50}$ of $344{\sim}368{\mu}g$/ml). In superoxide dismutase-like activity and reducing power, the fractions showed $20{\sim}25%$ of vitamin C, and $51{\sim}54%$ of butyl hydroxytoluene, respectively.

A Case of Severe Human Metapneumovirus Pneumonia Requiring Mechanical Ventilation in an Immunocompetent Adult (면역기능이 정상인 성인에서 발생한 Human Metapneumovirus 중증 폐렴 1예)

  • Lim, Hyo-Jeong;Lee, Jin Woo;Park, Young Sik;Kim, Nak-Hyun;Kim, Moonsuk;Yim, Jae-Joon;Yang, Seok-Chul;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Lee, Sang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.135-139
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    • 2009
  • Human metapneumovirus (hMPV) is a recently recognized human respiratory pathogen, which is known to be associated with upper and lower respiratory tract infections mainly in children, immunocompromised patients, and the elderly. The clinical manifestations of hMPV infections are similar to those of the human respiratory syncytial virus infection, which range from mild upper respiratory tract infection to severe bronchiolitis and pneumonia. Recently, hMPV has come to be thought of as the cause a similar spectrum of disease in adults as that seen in children; however, most of the reports of hMPV infections have focused on infection in children. We report a case of severe hMPV pneumonia requiring mechanical ventilation in an immunocompetent adult in Korea.

A Case of Methotrexate Induced Pneumonitis in a Patient with Rheumatoid Arthritis (류마티스 관절염 환자에서 Methotrexate에 의해 발생한 간질성 폐렴 1예)

  • Park, Chan Seok;Lee, Sang Haak;Shim, Kon Ho;Kim, Wan Uk;Lee, Sook Young;Kim, Seok Chan;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.273-277
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    • 2004
  • Methotrexate is commonly used in rheumatoid arthritis as an anti-inflammatory agent, but treatment with methotrexate can lead to severe side effects, especially pulmonary complication. Interstitial pneumonitis is one of the most important pulmonary adverse effects of methotrexate and most patient present with a subacute febrile illness and peripheral eosinophilia is seen in about a half of patients. Almost all patients have abnormal chest roentgenograms and bibasilar interstitial infiltration with alveolar pulmonary consolidations is the most characteristic finding. Interstitial inflammation with mononuclear cell infiltration is a characteristic pathologic feature and findings that suggest acute hypersensitivity pneumonitis, such as bronchiolitis, granuloma formation with giant cells, and infiltration with eosinophils are often present. Methotrexate-induced pneumonitis is a potentially life threatening and unpredictable complication but it is difficult to make a definite diagnosis in the absence of high index of clinical suspicion. Early recognition and appropriate management may avoid the serious outcome. Herein we report a case of methotrexate-induced pneumonitis in a patient with rheumatoid arthritis.

Active Surveillance of Pertussis in Infants Under 6 Months of Age: A Single Center Experience from 2011 to 2013 (생후 6개월 미만의 영아에서 백일해에 대한 적극적인 감시활동: 2011-2013년 단일기관 연구)

  • Han, Young Ik;Choi, Ji Yeon;Lee, Hyewon;Lee, Teak-Jin
    • Pediatric Infection and Vaccine
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    • v.21 no.2
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    • pp.114-120
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    • 2014
  • Purpose: The objective of this study was to assess and investigate the epidemiology of pertussis in infants under 6 months of age. Methods: A prospective study was conducted between October 1, 2011 and April 30, 2013 in CHA Bundang Medical Center, Seongnam, South Korea. Polymerase chain reaction (PCR) or culture was used to detect Bordetella pertussis in nasopharyngeal aspirates from case patients who were hospitalized for acute lower respiratory tract infection (LRTI). In addition, multiplex real-time PCR assays were also performed to detect 6 etiologic viruses, including adenovirus, human metapeumo-virus, influenza virus, parainfluenza virus, respiratory syncytial virus and rhinovirus. Results: Of the 79 enrolled case patients, whose median age was 2 months of age, the most common diagnoses uncovered in this study were acute bronchiolitis (60%) and pneumonia (28%). B. pertussis infection was found in 13 cases (16%), in which 7 (53%) was coinfected with respiratory syncytial virus and 1 (7%) with influenza A virus. Of the 13 patients with B. pertussis infection, 6 (46%) were not vaccinated with the diphtheria, tetanus toxoid, and acellular pertussis vaccine, while 6 (46%) received 1 dose, and 1 (8%) received 2 doses. Conclusion: B. pertussis infection was present in 16% of under 6 month-old infants, who were hospitalized for acute LRTI. Therefore, a nationwide epidemiological surveillance of pertussis, including institutions that cater to infants under 6 months of age is necessary and needed.

Clinical Manifestation of Human Metapneumovirus Infection in Korean Children (소아에서 human metapneumovirus 감염의 임상 특징)

  • Ahn, Jung Min;Choi, Seong Yeol;Kim, Dong Soo;Kim, Ki Hwan
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.28-35
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    • 2013
  • Purpose : The aim of this study was to determine the frequency, epidemiology and the clinical manifestation of human metapneumovirus (hMPV) infection in Korean children. Methods : From February 2010 to January 2012, we collected nasopharyngeal aspiration from 1,554 children who were hospitalized for acute lower respiratory tract infections at the Department of Pediatrics, Severance Children's Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. Results : We detected hMPV in 99 of the 1,554 hospitalized children. The mean age of the hMPV infected children was 25 months, and 87% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (73%) and bronchiolitis (16%). The clinical manifestations included cough, fever, respiratory distress, hoarseness, tachypnea, and wheezing. Coinfection with other respiratory viruses was found in 43 children (43%). Conclusion : hMPV is one of the major virus causing acute respiratory tract infection in the age between 13 months and 48 months old with peaks during April to June. Reports of hMPV in Korea has been increasing but additional studies are required to define the epidemiology and the extent of disease caused by hMPV to determine future development of this illness in Korean children.

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