• Tuberculosis and Respiratory Diseases
• /
• 제40권6호
• /
• pp.730-735
• /
• 1993

최근 저자들은 스테로이드에 잘 반응하나 재발을 잘하고 천명음이 동반된 BOOP 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
• /
• 제4권1호
• /
• pp.167-173
• /
• 1997

Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

• Tuberculosis and Respiratory Diseases
• /
• 제45권2호
• /
• pp.444-450
• /
• 1998

PCP remains the leading cause of deaths in patients with AIDS. As familiarity with PCP increases, atypical manifestations of the diseases are being recognized with greater frequency. There are following "atypical" manifestations of PCP ; 1) interstitial lung response that include diffuse alveolar damage, bronchiolitis obliterance, interstitial fibrosis, and lymphoplasmocytic infiltrate 2) striking localized process frequently exhibiting granulomatous features 3) extensive necrosis & cavitation 4) extrapulmonary dissemination of the disease. A wide variety of pathologic manifestations may occur in PCP in human immunodeficiency virus-infected patienst and that atypical features should be sought in lung biopsies from patients at risk for PCP. We had experienced a case of PCP, which presented with severe hypoxia, progressive dyspnea and fine crackles. It was diagnosed as PCP in AIDS with manifestation of BOOP by open lung biopsy and showed good response to Bactrim & corticosteroid therapy.

• 한국임상수의학회지
• /
• 제15권1호
• /
• pp.188-192
• /
• 1998

A 3-month old female Holstein calf was presented with about a month history of intermittent dyspnea, exercise intolerance and cough despite antibiotic therapy. Auscultation revealed prominent inspiratory and exploratory crackles and wheezes over the causal cervical trachea which were heard equally over both side of the chest.4 modest amount of forced exercise caused severe respiratory distress with stertorous noise and occasional honkinglike cough. Pasteurella spp. was isolated on the nasal swabs and a hemogram showed mild leucocytosis with a mature neutrophilia and mild monocytosis. Lateral radiographs of the neck and thorax revealed a marked narrowing of the tracheal lumen extending from the level of the fifth cervical to the second thoracic vertebra, and the lung field was judged to be within normal limitsi except very mild peribronchial thickening. The hypertrophic non-union fractures of the first pair of ribs were noted with a well delineatedr redundant callus formations and also the completely healed fractures were found on the next seven pairs of ribs. A diagnosis of tracheal collapse was made, which is thought to be a traumatic origin.4 poor prognosis was given. The calf was euthanatized and necropsied. The tracheal rings from 19th to 41s1 were collapsed dorsoventrally. Histologically, there was no difference between the collapsed and normal areas of the tracheae except the folding mucosal layer in the collapsed area. This report details a case of tracheal collapse in a calli and the literature is reviewed.

• 한국임상수의학회지
• /
• 제27권2호
• /
• pp.194-197
• /
• 2010

14세의 거세 마장마술마가 기침, 빈호흡, 점액농성의 비루를 호소하여 한국마사회 말보건원 동물병원에 내원하였다. 일반적인 광범위 항생제 치료를 3주간 실시하였으나 임상증상은 오히려 악화되었다. 이후 환자는 심한 기침과 점액농성의 비루, 빈호흡을 동반한 노력성 호흡, 운동능력저하 등의 임상증상과 기관세척액세포검사에서 심한 호중구성 염증이 관찰되어 만성폐쇄성폐질환으로 진단되었다. 마방 내 공기정화 노력과 병행한 3주간의 전신 글루코콜티코이드 치료를 실시한 결과 치료 후 임상증상이 현저히 개선되었다. 본 증례는 국내 말에서 다발하는 만성호흡기질환 중비감염성염증인 만성폐색성폐질환의 존재 가능성을 시사하였다. 향후 질병 발생 예방을 위해 말 사육 환경 내 존재하는 항원의 조사와 질병 발생율 조사가 필요할 것으로 판단된다.

• Tuberculosis and Respiratory Diseases
• /
• 제70권3호
• /
• pp.257-260
• /
• 2011

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

• Tuberculosis and Respiratory Diseases
• /
• 제83권4호
• /
• pp.312-320
• /
• 2020

Background: Systemic sclerosis (SSc) involves multiple organ systems and has the highest mortality among connective tissue diseases. Interstitial lung disease is the most common cause of death among SSc patients and requires closer studies and follow-ups. This study aimed to identify lung function changes and predictors of progressive disease in systemic sclerosis-related interstitial lung disease (SSc-ILD). Methods: A retrospective study extracted SSc patients from an electronic database January 2002-July 2019. Eligible cases were SSc patients >age 15 diagnosed with SSc-ILD. Factors associated with progressive disease were analyzed by univariate and multivariate logistic regression analyses. Results: Seventy-eight SSc-ILD cases were enrolled. Sixty-five patients (83.3%) were female, with mean age of 44.7±14.4, and 50 (64.1%) were diffuse type SSc-ILD. Most SSc-ILD patients had crackles (75.6%) and dyspnea on exertion (71.8%), and 19.2% of the SSc-ILD patients had no abnormal respiratory symptoms but had abnormal chest radiographic findings. The most common diagnosis of SSc-ILD patients was non-specific interstitial pneumonia (43.6%). The lung function values of diffusing capacity of the lung for carbon monoxide (DLCO) and DLCO per unit alveolar volume declined in progressive SSc-ILD during a 12-month follow-up. Male and no previous aspirin treatment were the two significant predictive factors of progressive SSc-ILD with adjusted odds ratios of 5.72 and 4.99, respectively. Conclusion: This present study showed that short-term lung function had declined during the 12-month follow-up in progressive SSc-ILD. The predictive factors in progressive SSc-ILD were male sex and no previous aspirin treatment. Close follow-up of the pulmonary function tests is necessary for early detection of progressive disease.

• Journal of Yeungnam Medical Science
• /
• 제35권1호
• /
• pp.84-88
• /
• 2018

A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

• Tuberculosis and Respiratory Diseases
• /
• 제52권4호
• /
• pp.411-418
• /
• 2002

저자 등은 폐결핵재발 후에 진행성의 호흡곤란과 만성기침을 호소하며 입원하여 흉부전산화 단층촬영 상에 폐포단백증의 특징적인 소견을 보이는 환자를 개흉 폐생검으로 확진하여 항결핵제 투여와 기관지폐포세척술로 임상적 호전을 보인 1예를 문헌고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
• /
• 제3권2호
• /
• pp.154-162
• /
• 1996

Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.