• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.89-93
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• 2014

Background: This study was conducted to investigate the epidemiological features, clinical courses, and diagnoses of neonates who are transferred to neonatal intensive care unit of Yeungnam University Hospital due to tachypnea soon after birth. Methods: Based on medical records, we performed a retrospective study of neonatal intensive care unit admissions due to tachypnea from January 2010 to December 2013. Results: A total of 311 neonates were included in this study. The patient characteristics showed male predominance at 2.65:1. Among the 311 neonates with tachypnea, 127 (40.8%) neonates needed oxygen supply, and 54 (17.4%) neonates needed assisted mechanical ventilation. Transient tachypnea of the newborns (TTN) (158, 50.8%) showed the highest incidence, followed by pneumonia (63, 20.3%), extrapulmonary infection (37, 11.9%), respiratory distress syndrome (21, 6.8%), air leak (16, 5.1%), meconium aspiration syndrome (12, 3.9%), congenital heart disease (5, 1.6%), metabolic acidosis (3, 1%), primary pulmonary hypertension of newborns (2, 0.6%) and anemia (2, 0.6%). Conclusion: Although the neonates with tachypnea showed no other respiratory distress symptom, clinicians should be aware of the possibility of other pulmonary diseases as well as TTN and their extra-pulmonary causes. If tachypnea does not improve within a few hours, the clinician should consider further evaluation and management as soon as possible.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.349-357
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• 2010

목 적 : TTN은 대부분의 경우 출생 24-72시간 이내에 좋아지는 것으로 알려져 있으나 때로는 72시간 이상 빈호흡이 지속되며 심각한 저산소증과 호흡부전, 기흉 등의 합병증이나 사망에까지 이르기도 한다. 지금까지 이러한 지속성 TTN에 대한 연구가 드물어 이들에 대한 발생 위험인자와 임상경과를 알아보고자 본 연구를 시행하였다. 방 법 : 2001년 1월 1일부터 2007년 9월 30일까지 서울아산 병원에서 출생한 12,021명의 신생아 중 신생아 중환자실에 입원하여 TTN으로 진단받은 재태연령 $35^{+0}$주 이상의 신생아 107명을 대상으로 환아와 그 어머니의 의무기록을 후향적으로 검토, 분석하였다. 빈호흡에 대한 다른 기저 질환 없이 빈호흡이 생후 72시간 이상 지속되는 경우를 PTTN으로 정의하고 빈호흡이 출생 72시간 이전에 호전되는 경우를 STTN으로 구분하여 TTN의 위험인자와 임상경과를 비교하였다. 대조군은 같은 기간 동안 신생아실에 입원한 정상 신생아 126명을 무작위로 선택하여 비교하였다. 결 과 : 전체 TTN환아 107명 중 55명(51%)이 PTTN에 해당하였다. PTTN군에서 출생 6시간 이내 발생하는 끙끙거림(grunting)의 빈도, 분당 90회 이상의 빈호흡, 산소 치료농도 0.4 이상, 기흉, 보조적 호흡기 치료 등이 빈번하였고 출생 첫날 측정한 총 단백과 알부민, 체중 감소 비율이 STTN군에 비해 낮았다. PTTN의 발생과 가장 관련 있는 예측 위험 인자로는 출생 6시간 이내 발생한 끙끙거림, 최대 호흡수가 90회 이상, 산소 치료농도가 0.4 이상인 경우 등이었다. 결 론 : TTN 환아에서 출생 6시간 이내의 끙끙거림, 최대 호흡수 분당 90회 이상, $FiO_2$ 0.4 이상인 경우 등의 위험 인자가 있는 경우 더 나쁜 임상 경과를 보일 것으로 예측할 수 있을 것이다. PTTN의 발생을 낮추고 질환의 빈도와 증상을 줄일 수 있는 방법에 대한 더 많은 연구가 필요하다.

• Clinical and Experimental Pediatrics
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• 제53권1호
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• pp.1-6
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• 2010

Transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension of the newborn (PPHN) are the three most common disorders that cause respiratory distress after birth. An understanding of the pathophysiology of these disorders and the development of effective therapeutic strategies is required to control these conditions. Here, we review recent papers on the pathogenesis and treatment of neonatal respiratory disease.

• Neonatal Medicine
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• 제25권2호
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• pp.66-71
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• 2018

Purpose: Respiratory morbidity is the most common problem among neonates admitted to neonatal intensive care units. Therefore, the aim of this study was to make a differential diagnosis between transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and pneumonia through comparison of clinical features and test results. Methods: This retrospective study was conducted in 86 infants with TTN, RDS, or pneumonia. These were infants who had respiratory distress, were born after ${\geq}34$ weeks of gestation, and transferred to the neonatal intensive care unit of Kosin University Gospel Hospital between June 1, 2011 and June 30, 2016. Results: The numbers (percentage) of infants with TTN, RDS, and pneumonia were 51 (59.3%), 20 (23.3%), and 15 (17.4%), respectively. Late-preterm and early-term newborns accounted for 65.1% of the infants. Tachypnea was observed in 74.4% of the neonates. The median age at admission was 4 hours (0 to 116) after birth. The infants with RDS had significantly lower birth weights, pH levels, base excess and oxygen saturation levels at admission, longer duration of total ventilator therapy, and hospital stay than those in the other two groups. The infants with pneumonia showed significantly high initial high-sensitivity C-reactive protein levels and significant chest radiographic findings. Conclusion: Early differential diagnosis for TTN, RDS, and pneumonia is challenging because they show similar respiratory symptoms at an early stage. Clinical features and test results can be used to determine the etiology of respiratory distress and early antibiotic treatment.

• 대한한방내과학회지
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• 제3권1호
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• pp.41-48
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• 1986

1. The cause of Pehuh is deficiency of Peki(肺氣). Symptoms are tachypnea, thirst and deafness of hemoptysis. In treatment, control it's Ki(氣). 2. The cause of Peson is in addition to Pehuh Pimo(皮毛) is demaged by heat and cold. Symptoms are alopecia, cough, sputum, fever and chill. In treatment, supply it's Ki. 3. The cause of Pero is it's Ki which is demaged by lie down for a long time or because of anxiety Sang Ryum Hueng Kum(上炎刑金). Symptoms are tachypnea, chest and back pain, cough and sputum. In treatment, supply Sinki(腎氣). 4. In correlation of Pehuh, Peson and Pero, Pehuh is progressed from Kihuh(氣虛), Peson is progressed from Pehuh and Pero is progressed from Peson. 5. The treatment of Lung disease showed by chapter Huhro(虛勞). In early stage, control it's Ki. In middle stage, supply it's Ki. The last stage, supply Sinki(腎氣).

• 한국임상수의학회지
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• 제2권1호
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• pp.79-104
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• 1985

Clinical and cytomorphological studies were carried out in 32 leukotic cattle from Tokachi and Kushiro districts in Hokkaido during the 12 year period from 1969 to 1980. The leukotic cattle were examined :and divided into four types(15 cases of the adult, 11 cases of the thymic, 4 casas of the calf and 2 cases of the skin types). The results obtained were as follows : 1. As for the frequency of the main clinical signs in each type, In the adult type, the main clinical signs (of decreasing order) are as follows: swelling of the superficial lymph nodes>depression and loss of weight>tachycardia>anorekia, anemia of the visible mucous membrane and tachypnea. Those of the thymic type were swelling of the thymus>swelling of the medial iliac lymph nodes> swelling of the superficial lymph nodes>tachypnea. Those of the calf type were swelling of the auperficial lymph nodes>depression and emaciation>tachypnea>anorexia, tachycardia, anemia of the visible mucous membrane and recumbency. Those of the skin type were generalized urticaria-like lesions in skin and swelling of superficial lymph nodes>and depression and loss of weight in the decreasing order of frequency. In addition, large tumor mass in the pelvic cavity and swelling of the medial iliac lymph nodes were detected through rectal palpation in 33.3% and 100% in the adult type cases, respectively. 2. As for the hematological findings, The frequency of occurrence of decreased erythrocyte counts in the decreasing order were as follows : adult>calf>thymic>and skin types. The increase in the total leukocyte count in the order of decreasing frequency were as follows: calf>thymic>adult>and skin types. The increase in the absolute lymphocyte counts was found to be at a low rate, 62.5% of all the cases examined. By contrast, the increase of 5% or more of abnormal lymphocyte rates was observed at a high rate, 96.9% of the total cases. 3. Abnormal lymphocytes were found in all cases examined for lymph nodes biopsied. 4. From the cytomorphological point of view, leukotic cells were divided into 3 types: reticulum cell, lymphoid cell and monocytic cell types. The adult type leukotic cattle were divided with reticulum cell type (66.7%), the lymphoid cell type(22.6%) and monocytic cell type(6.7%). The thymic type was lymphoip cell type(72.7%) and reticulum cell type(27.3%). In the calf type, all were lymphoid cell type while all of the skin type were reticulum cell type only. 5. The leukotic cattle had higher NP frequency in the blood and lymphoid tissue than non-1 eukotic cattle. Especially the adult type had the highest NP frequency. However, it was not recognized that NP were characteristic of leukotic cattle alone. 6. The above findings lead to the conclusion that the most effective diagnostic methods for bovine leukosis are the confirmation of swelling of the superficial and internal lymph nodes and thymus in addition to appearance of abnormal neoplastic cell in the peripheral blood and lymph nodes biopsied.

• Tuberculosis and Respiratory Diseases
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• 제54권1호
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• pp.5-14
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• 2003

연구배경 : ICOPER 보고에 의하면 급성 폐혈전색전증 발생 3개월내 사망률이 17.4%이며, 일본 조사에서는 사망률이 14%라고 보고하였다. 그러나 국내에서는 급성 폐혈전색전증의 전국 규모의 대단위 연구가 없어서, 그 현황에 대해 보고된 바 없었다. 따라서 본 학회에서는 급성 폐혈전색전증에 대한 전국 실태조사를 시행하였다. 방법 : 1998년 1월 1일부터 2000년 12월 31일까지 전국수련병원급 이상 종합병원에서 급성 폐혈전색전증으로 진단받은 환자를 대상으로 역학적 특성, 임상양상, 진단법, 위험인자, 치료, 임상경과 등을 조사하였다. 결과 : 환자들의 평균연령은 $58.3({\pm}16.3)$세 였고, 남자가 40.3%였다. 발생 위험인자로는 장기간의 부동상태, 수술, 악성종양이 각각 22.9, 19.2, 15.8% 였다. 가장 흔한 증상으로는 호흡곤란과 흉통이었다. 진단을 위한 검사방법으로는 폐관류 스캔을 시행한 경우가 가장 많았다. 흉부 방사선 검사상 정상 소견을 보인 경우가 53.5%로 가장 많았고, 이상 소견으로는 흉막 삼출액이 가장 흔하였다. 치료방법으로는 86.8%에서 헤파린 항 응고법을 시행하였고 혈전 용해요법은 시행한 경우는 12.3%였다. 사망을 예측할 수 있는 인자로는 병원내에서 이환된 경우, 폐암, 빈호흡, 쇼크, 청색증의 5가지로 분석되었고, 사망 위험도는 각각 1.88, 9.20, 3.50, 6.74, 3.45배 였다. 전체 사망률은 16.9%였고 그 중에서 급성 폐혈전색전증과 연관된 사망률은 9.0%였다. 결론 : 본 조사는 급성 폐혈전색전증에 대한 최초의 전국규모의 실태조사로서, 이 결과가 향후 국내 급성폐혈전색전증의 연구와 치료에 기여할 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제13권3호
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• pp.292-297
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• 1980

The congenital cystic adenomatoid malformation of the lung consists of an enlarged, meaty, multicystic lobe with smooth-walled cysts of varying sizes, which can communicate with major bronchi through malformed air passages that usually lacks cartilage. This abnormality is usually symptomatic in infancy with signs of respiratory distress such as tachypnea, substernal retraction and cyanosis. Prompt surgical resection is choice of treatment in life-threatening respiratory distress patients. We recently experienced a case of congenital cystic adenomatoid malformation of the lung in a patient with situs inversus totalis. The patient was 40 days old female who showed severe respiratory difficulty. Emergency left middle lobectomy was undergone successfully. Her postoperative course was uneventful. She was discharged from hospital on the postoperative eighth day in good condition.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.43-47
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• 2004

We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

• Journal of Chest Surgery
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• 제15권2호
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• pp.230-237
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• 1982

Malignant hyperthermia has been reported by many authors since Denborough [1960] first described concerning anesthetic death in a family. Malignant hyperthermia is characterized by a hypermetabolic state [tachycardia, tachypnea, hypercarbia, hypoxia, cyanosis, hypotension, high fever and muscle rigidity] and is related to a hereditary defect of skeletal muscle. In susceptible individuals, it is triggered by potent inhalational anesthetics, depolarizing muscle relaxant [Succinylcholine], amide type local anesthetics [prototype lidocaine] and occasionally by stress due to emotional and environmental factors. Unrecognized and untreated malignant hyperthermia is associated with a very high mortality rate. Recently authors have experienced malignant hyperthermia in 5 year old male child who was diagnosed to have patent ductus arteriosus and interatrial septal defect associated with congenital physical deformities such as short stature, hypotrophic muscles and genu valgus deformity of lower extremity, indirect inguinal hernia and Ramphant caries.