• Title/Summary/Keyword: Severe pneumonia

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Distribution of Legionella species from water systems and genetic diversity of L. pneumophila serogroup 1 in Gyeonggi-do (경기도내 수계시설에서 분리된 레지오넬라균의 분포현황 및 Legionella pneumophila serogroup 1의 유전학적 다양성 연구)

  • Lee, Hyun-Kyung;Park, Yong-Bae;Hwang, Sun-Il;Kim, Young-Su;Park, Nan-Joo;Park, Kwang-Hee;Yoon, Mi-Hye
    • Korean Journal of Microbiology
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    • v.53 no.3
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    • pp.156-162
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    • 2017
  • Legionnaires' disease (LD) is a severe and potentially fatal pneumonia caused by colonization of human-made water system and subsequent aerosolization and inhalation of Legionella bacteria. A total of 147 Legionella strains was isolated from environmental water sources from public facilities in Gyeonggi-do, South Korea. The distribution of Legionella isolates was investigated according to facility type, and sample type. L. pneumophila was distributed broadly throughout Gyeonggi-do, accounting for 85.7% of the isolates, and L. pneumophila serogroup (sg) 1 predominated in all of the public facilities. L. wadsworthii predominated among non-L. pneumophila species. We performed comparative analyses of L. pneumophila sg 1 isolated from environment water of public facilities in Gyeonggi-do by pulsed field gel electrophoresis (PFGE) and sequence-based typing (SBT). Thirty-two isolates were classified into 22 types by PFGE and 9 sequence types (STs) by SBT and categorized into 3 groups. ST1 was the most prevalent sequence type and two STs obtained in this study had unique allelic profiles. The use of SBT data from different countries for epidemiology study of LD constitutes a technically uncomplicated and relatively easy method for strain subtyping, especially compared to other contemporary techniques.

Clinical Observation on a Case of Patient with Amyotrophic Lateral Sclerosis (근위축성 측삭 경화증 환자 치험 1례)

  • Choi, Eun-Hee;Jeon, Ju-Hyun;Kim, Yeon-Mi;Lee, Jae-Min;Go, Seung-Kyoung;Kang, Min-Wan;Kim, Sung-Lae;Yang, Gi-Young;Kim, Young-Il;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.225-235
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    • 2007
  • Amyotrophic Lateral Sclerosis(ALS) is Motor Neuron Disease(MND) that reveals muscle relaxation, bulbar palsy, extremities weakness, Pneumonia, in severe case, leads to death. Objectives : Amyotrophic Lateral Sclerosis is one of the incurable disease. In Oriental medicine, Wei symptom is similar as Amyotrophic Lateral Sclerosis, so we diagnosed it as Wei symptom and treated in Oriental medical system. Methods : The patient was treated by acupunture, moxibustion, herb medication, physical treatment. The improvement of the patient was judged by Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), Grasping power on right arm, circumference of thigh and calf. Result : The patient had better condition for a while but the sputum irritated breathing and the day before he discharged vital sign was not stable and could not breath well. Conclusion : It is necessary to have more examination about the incurable syndromes such as Amyotrophic Lateral Sclerosis, and keep the patient's life better and expand their lives.

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A Case of Broncho-esophageal Fistula Associated with Bronchiectasis (기관지확장증과 동반된 식도기관지루 1례)

  • Chung, Hyuck-Joon;Ku, Sung-Hyun;Lee, Sun-Min;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong;Han, Myung-Ho;Kim, Yung-Jin;Lee, Chul-Ju;Lee, Ki-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.729-734
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    • 1999
  • Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

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Teratoma Presenting as An Unilateral Mediastinal Mass with Contralateral Pleural Effusion (편측성 종격동 종괴와 반대측 흉수로 발현된 기형종 1예)

  • Ha, Eun Sil;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Jo, Won Min;Lee, Sang Yeub;Kim, Je-Hyeong;Lee, Eung Seok;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.347-352
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    • 2006
  • A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.

A Clinical study on Pediatric Bronchial Asthma (소아천식에 대한 임상적 고찰)

  • Kim, Yun-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.1
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    • pp.133-148
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    • 2002
  • Objective : This study was to investigate more effective oriental medical treatment for Pediatric Bronchial Asthma Method : Aroma therapy and Herbal medicine was given to 28 pediatric bronchial asthma patients(19 males and 9 females) for about 5months from the First, August 1999 The Fifth, January 2002. Results: 1. Demographic factor : The sample consisted of 28 persons among whom 19 were male, 9 were female. The age ranges from 1 year old to 6 year old. Less than 2 year old were 4 and 2-6 year old were 20. 2.Residence : Apartment and villar dwellers were 19(67.9%), Residential street divellers were 9(32.1%). 3.Age distribution at on set : 6(21.4%) fell ill befor 1 year old and 22(78.6%) fell ill after 1 year old 4. The period of illness : 9(32.2%) suffered during 1-3 year and 6(21.4%) suffered during 6 mouth-1year and 6(21.4%) suffered during more than 3 year. 5. Frequency of the symptoms : The symptoms appeared 2-3 times a year in the case of 16(57.2%), one time a year in the case of 1, 4 times a year in the case of 6(21.4%). 6. Concomitance symptoms : All experienced coughing sign, wheezing, 23(82.1%) experienced epistaxis, nose dripping, 13(46.4%) got fever, anorexia. 7. Past history of illness : 16(57.1%) got brochiolitis, brochitis, 12(42.9%) suffered pneumonia, 9(32.1%) had allergic rhinitis. 2 had allergic rhinitis, sinusitis, atopic dermatitis, bronchial asthma, 3 got atopic dermatitis, bronchial asthma and 7 had allergic rhinitis, sinusitis, bronchial asthma, 8. Family disease : In the case of family disease, 21(75%) had allergic dermatitis, 9(42.9%) had bronchial asthma, 8(38.1%) had allergic dermatitis. 9. The symptoms became very severe in the change of season in the case of 13(46.4%) and in the case of 11(39.3%), the change of season made no difference 10. Associated caused of induction symtoms : 28(100%) got sick by common cold, infectional disease, 8(28.6%) got sick by cold food, cold air 11.The kind of therapy : 15(53.6%) got oriental therapy after occidental therapy, 11(39.3%) took only oriental therapy. 12. Improvement degree of each symptoms : In the case of cough and wheeze that are the main symptoms of bronchial asthma, 78.6% and 64.3% of the patients replied < improvement > and in the case of dyspnea, tachypnea 41.7% of the patients replied . In other symptoms, all replied 13. Degree of satisfaction : 19(67.9%) replied , 2(7.1%) replied . Conclusion : Herbal medicine and aroma therapy proved to be a very effective oriental medical treatment for pediatric bronchial asthma.

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Surgical Options for Malignant Mesothelioma: A Single-Center Experience

  • Kang, Seung Ri;Bok, Jin San;Lee, Geun Dong;Choi, Se Hoon;Kim, Hyeong Ryul;Kim, Dong Kwan;Park, Seung-Il;Kim, Yong-Hee
    • Journal of Chest Surgery
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    • v.51 no.3
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    • pp.195-201
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    • 2018
  • Background: We investigated the surgical outcomes of patients who underwent therapeutic surgery for malignant pleural mesothelioma (MPM) at a single center. Methods: A retrospective review of 21 patients who underwent therapeutic surgery for MPM from January 2001 to June 2015 was conducted to assess their outcomes. The patients' characteristics and postoperative course, including complications, mortality, overall survival, and recurrence-free survival, were analyzed. Results: Of the 21 patients who underwent therapeutic surgery, 1 5 (71.4%) underwent extrapleural pneumonectomy, 2 pleurectomy (9.5%), and 4 excision (1 9.1 %). The median age was 57 years (range, 32-79 years) and 15 were men (71.4%). The mean hospital stay was 1 6 days (range, 1-63 days). Median survival was 14.3 months. The survival rate was 54.2%, 35.6%, and 21.3% at 1, 3, and 5 years, respectively. In patients' postoperative course, heart failure was a major complication, occurring in 3 patients (14.3%). The in-hospital mortality rate was 2 of 21 (9.5%) due to a case of severe pneumonia and a case of acute heart failure. Conclusion: A fair 5-year survival rate of 21.3% was observed after surgical treatment. Heart failure was a major complication in our cohort. Various surgical methods can be utilized with MPM, each with its own benefits, taking into consideration the severity of the disease and the comorbidities of the patient. Patients with local recurrence may be candidates for surgical intervention, with possible satisfying results.

Cryoanalgesia for the Post-thoracotomy Pain (늑간 신경 냉동요법에 의한 개흉술후 흉부 동통 관리)

  • Kim, Uk-Jin;Choe, Yeong-Ho;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.54-63
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    • 1991
  • Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

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A clinical Study on Pediatric Bronchoarthma (II) (소아기관지(小兒氣管支) 천식(喘息)의 임상적(臨床的) 고찰(考察 ) (제(第)II보(報)))

  • Jeong Gyu-Mann;Kim Deog-Gon;Lee Dong-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.1 no.1
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    • pp.79-89
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    • 1986
  • During 34 months from October 1982 to July 1985, a clinical study was made on 217 cases of out-patients with pediatric bronchoarthma at Kyung-Hee University Oriental Hospital. ?The observed results were as follows; ?1. In the age of the patients ranged from six months to twelve years; they were almost under six years (73.1 %) The ratio of male to female was 3: 1. ?2. In case of the age to be attacked with bronchoarthma, the age 3 covered 43.9% (95 cases), and the ages of less than 6 years 86.3% (187 cases); and, especially, the age 2 - 3 covered the highest rate (18.4%; 40 cases) ?3. The contraction period of bronchoarthma was almost less than one year (70.1%; 152 cases); especially, less than one week covered the highest rate (22.1 %; 48 cases) ?4. In case of the contraction season; winter (December to February) had the highest rate (33.2%; 72 cases), and fall, spring and summer came after it. And 13 cases (6%) were attacked in all seasons. ?5. Of a day, the severe symptom was shown most frequently from 6 pm to midnight (31.3%; 68 cases), and next from midnight to 6 am (29.1%; 62 cases) ?6. The common symptoms of out-patients were productive cough (24.0%; 147 cases), easily-catch-cold (22.5%; 138 cases), dry cough (11.4%; 70 cases), and so on. ?7. In case of the history of the patients, upper respiratory infections covered 52.1 % (113 cases) bronchitis(29.0%; 63 cases), pneumonia(17.1%; 37 cases), and tonsilitis& pharyngitis(6.0%; ?13 cases): and allergic symptoms covered (42 cases: 19.3%) fetal fever & eczema (11.5%: 25 cases), and allergie Rhinitis (7.8%: 17 cases) ?8. The family of the patients were shown to have the history of bronchitis (21.6%; 47 cases), bronchoarthma (21.2%; 46 cases), and tuberculosis (16.6%; 36 cases) ?9. The factors of bronchoarthma were shown as upper respiratory infections (38.3%; 38 cases), cold weather (18.9%; 41 cases), and exercise (175%; 38 cases) ?10. Of the treatment periods of the patients, less than one month (69.2%; 150 cases) took the highest rate, in which less than a week was 33.2% (72 cases) and one or two weeks 15.2% (33 cases) ?11. The main prescriptions were kunpyunetang (79 cases; 17.0%), Agoayangyuegunpyuetang (73 cases; 15.7%) and Haepyoyangjintang (72 cases; 15.6%) ?12. In the results of treatment, 132 cases (60.9%) was improved; especially, subjective signs of 33 cases (15.2%) of them, was almost removed.

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Epidemiologic and Clinical Features of Pertussis in Children(2000. 3-2001. 3) (소아 백일해 감염의 유행 및 임상 양상(2000. 3-2001. 3))

  • Yoo, Shin;Ahn, Kyong Ouk;Park, Eun Hye;Cho, Hyun Sang;Park, Chong Young;Lee, Hae Ran
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.603-608
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    • 2002
  • Purpose : Pertussis is a highly communicable infectious disease in children with high mortality, especially in young infants. The incidence of pertussis in South Korea has decreased to about 10 cases a year in late '90s. Doubting previously reported incidences of pertussis, we designed this study to establish exact epidemiology and a diagnostic basis of pertussis. Methods : From Mar. 2000 to Mar. 2001, polymerase chain reaction(PCR) and cultures of nasopharyngeal aspirates were taken from 49 patients who were clinically suspected of pertussis in Kangdong Sacred Heart Hospital. Results : Among 49 patients suspected of pertussis, 10 cases showed positive results by PCR method. Four out of those 10 cases were positive in culture. The peak outbreak was noticed in the spring(Mar.-May) and the autumn(Sep.-Nov.). The mean age of the patients was 3.6 months. Eight of the 10 cases which were PCR positive results proved not to be immunized against pertussis. Conclusion : Most of the pertussis patients in our study were diagnosed as bronchiolitis, pneumonia or bronchitis at the beginning of the disease and only a few patients showed typical clinical manifestations of pertussis, including whooping. When the above results are taken together, we suggest the possibility that the actual prevalence of pertussis in South Korea might be higher than that of previous reports. The importance of pertussis screen tests should be emphasized in children with severe coughs.

Study on gross finding of lung lesions and causative pathogens of porcine respiratory disease complex from slaughtered pigs in Incheon (인천지역 도축돈에서 돼지호흡기질병복합감염증의 육안적 폐병변과 원인체에 관한 연구)

  • Lee, Chang-Hee;Hwang, Weon-Moo;Lee, Jung-Goo;Lee, Sung-Mo;Kim, Sung-Jae;Kim, Nam-Hee;Yang, Don-Sik;Han, Jeong-Hee
    • Korean Journal of Veterinary Service
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    • v.34 no.4
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    • pp.313-320
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    • 2011
  • The purpose of this study was to investigate association with gross lesions and causative pathogens of porcine respiratory disease complex (PRDC) including porcine circovirus type 2 (PCV2), porcine reproductive and respiratory syndrome virus (PRRSV), swine influenza virus (SIV), Mycoplasma hyopneumoniae (MH), Pasteurella multocida (PM), Actinobacillus pleuropneumoniae (APP), Haemophilus parasuis (HP) in slaughtered pigs. A total of 1,200 lung samples were collected randomly from slaughtered pigs in Korea during August of 2010 through July of 2011. The gross lesions were classified according to the six stages (0, 1~10, 11~20, 21~30, 31~40 and ${\geq}41$, unit=%) and 48 samples from each stage were selected to detect viral and bacterial pathogens. The results according to the six stages were 100 (8.3%), 259 (21.6%), 326 (27.2%), 213 (17.8%), 144 (12.0%) and 158 (13.2%) cases, respectively. Prevalence of pneumonia according to season was 87.0~96.7% and the highest prevalence was in spring. In detection of pathogens by PCR, 53 samples were not detected any causative pathogens of PRDC. PCV2, PRRSV, SIV, MH, PM, APP serotype 2, APP serotype 5 and HP were positive in 45.5%, 12.5%, 10.4%, 60.1%, 1.7%, 13.9%, 12.2% and 15.6%, respectively. In co-infection, PCV2-MH was the most detected causative pathogens of PRDC. The detection rate of PCV2 and PRRSV was the highest in spring, of SIV, MH and HP was in winter. The detection rate of APP-2 and APP-5 had no seasonal prevalence. The more severe gross lesions increased, the higher the detection rate showed.