• Clinical and Experimental Pediatrics
• /
• 제65권4호
• /
• pp.188-193
• /
• 2022

Background: Respiratory distress syndrome (RDS) is a common cause of hospitalization and death in preterm infants who require surfactant treatment and respiratory support. Purpose: This study aimed to compare the clinical outcomes of minimally invasive surfactant therapy (MIST) and the INtubation, SURfactant administration, and Extubation (INSURE) technique in preterm infants with RDS. Methods: In this clinical trial, 112 preterm infants born at 28-36 weeks of gestation and diagnosed with RDS randomly received 200-mg/kg surfactant by MIST or the INSURE method. In the MIST group, surfactant was administered using a thin catheter (5F feeding tube); in the INSURE group, surfactant was administered after intubation using a feeding tube and the tracheal tube was removed after positive pressure ventilation was started. Nasal continuous positive airway pressure was applied in both groups for respiratory support and the postprocedure clinical outcomes were compared. Results: The mean hospitalization time was shorter for infants in the MIST group than for those in the INSURE group (9.19±1.72 days vs. 10.21±2.15 days, P=0.006). Patent ductus arteriosus was less frequent in the MIST group (14.3% vs. 30.4%, P=0.041). Desaturation during surfactant administration occurred less commonly in the MIST group (19.6% vs. 39.3%, P=0.023). There were no significant intergroup differences in other early or late complications. Conclusion: These results suggest that surfactant administration using MIST could be a good replacement for INSURE in preterm infants with RDS since its use reduced the hospitalization time and the number of side effects.

• 약학회지
• /
• 제41권6호
• /
• pp.797-801
• /
• 1997

Recently we reported that water extracts of Coptidis Rhizomas showed calcium antagonistic action and alpha-adrenoceptor inhibitory action in the vascular smooth muscle. Since ca lcium antagonistic properties are important in the treatment of various diseases including asthma. In the present study, the bronchodilatory effects of crude extract of three kinds of Coptidis Rhizoma (Coptidis chinensis, Coptis japonica and root hair of Coptis japonica) was investigated using rat isolated trachea. The result showed that all extracts relaxed carbachol-contracted tracheal smooth muscle. Concentration-dependently, in which the root hair of Coptis japonica was the least potent. The inhibitory potency expressed in terms of $IC_{50}$ against carbachol contraction was 1.8${\mu}$g/ml and 2.7${\mu}$g/ml for Coptidis chinensis and Coptis japonica, respectively. These extracts also inhibited KCI-contracted tracheal smooth muscle. But the relative potency ($IC_{50}$) was 3.5 and 4.1 folds weaker than carbachol-induced contraction for Coptidics chinenesis and Coptis japonica, respectively. Pretreatment of crude extracts also inhibited carbachol- or KCI-induced contraction, non-competitively. These findings indicate that the extracts have muscarinic blocking as well as $Ca^{2+}$ channel blocking action. When provoked intracellular stored $Ca^{2+}$ release by carbachol in $Ca^{2+}$-free conditions, initial phasic contraction due to $Ca^{2+}$ release was significantly inhibited by the extracts. As taken together, we conclude that water extracts of Coptidis Rhizoma may be beneficial in bronchospasm or other broncheal tube narrowing conditions such as asthma.

• 한국임상수의학회지
• /
• 제20권4호
• /
• pp.496-500
• /
• 2003

A one-year-old male Japanese Chin with anorexia, retching, dyspnea and continuous coughing was brought to the Veterinary Teaching Hospital, Chungbuk National University. Chest radiographs showed moderate regional alveolar pattern with mild interstitial patterns in the caudo-dorsal lung fields and the ill-defined mass in the perihilar area which is consistent with perihilar lymphadenopathy. Although the dog showed severe eosinophilia in the complete blood count, the serum profile values were within normal ranges. There was no indication of any parasite infestation in the direct and floatation examination of feces, skin scraping test and heartworm examination. There was no growth of bacteria and fungi in the selected media such as Mueller Hinton broth, Sabouraud Dextrose agar and Potato Dextorse agar, which were inoculated with tracheal fluid collected using endotracheal tube and cultured for 3 days. In the tracheal fluid smear, most prominent cells were eosinophils, which are a almost 80% of total cells and other cells such as leukocytes, neutrophils and ciliated colummar cells were also observed. Any parasite was also not detected in its smear. Prednisolone (PDS; 1 mg/kg, BID SC), aminophylline (10 mg/kg, TID IV) and nebulization with gentamicin (50 mg) plus saline (3 ml) were given for 1 week. At 3rd day of treatment, blood eosinophil value was return to normal range and pulmonary condition was also improved. The allergen test with serum performed during therapy was positive in the 19 index including milk, barley, tomato pomace, catfish, bonito, house dust and wool, and borderline in 10 index including wheat, house dust mites and house fly. The patient is responding well to PDS therapy. Based on these findings, a possible diagnosis of pulmonary infiltration with eosinophils was made in this dog.

• Tuberculosis and Respiratory Diseases
• /
• 제39권4호
• /
• pp.318-324
• /
• 1992

기관지내 팽창성 금속 스텐트의 사용은, 아직은 외국의 경우에서도, 추적 관찰기간이 짧고 시술받은 환자의 수도 많지 않으며 장기간 삽입후의 변화에 대하여는 그 결과가 예측하기 힘들다는 점등을 생각할 때는 현재 이의 시행은 아직은 실험적 단계라 할 수 있다. 그러나 내과적 혹은 외과적인 문제로 수술적 기관지 보존술등을 시행받기 어려운 상태에 있는 기관지 협착환자에서는 단독으로, 혹은 laser therapy, electrocoagulation, cryotherapy, balloon dilatation 및 다른 tracheal devices (예(例): Montgomery T-tube)등 의 치료방법들과 같이 병행하여, 팽창성 금속 스텐트의 삽입은 기관기관지 협착증의 치료에 도움이 되리라 생각된다. 또 국내에서는 아직도 유병율이 높은 폐결핵환자에서 충분한 기간동안 약물치료후에도 일부 환자에서는 기관지 결핵에 의하여 기관지 협착이 발생하는데 이때 수술적 치료외에는 적절한 치료방법이 없는 실정이다. 이러한 환자에서 만약 협착부위가 한쪽 주 기관지에 부분적으로 국한 되어 있으며 그 이하의 폐실질파괴가 심하지 않다면 스텐트 삽입은 수술적 치료이전에 시도하여 볼 수 있으리라 사료된다.

• 가정간호학회지
• /
• 제9권1호
• /
• pp.5-13
• /
• 2002

This study was conducted to assess need for education on the infection control by examining the knowledge on infection control in home care of the home care trainees who had completed an infection control course. Using 64 items questionnaire. home care trainees of eight home care education institutions who took classes related with infection control. The level of knowledge evaluated subjectively was 4.24point (full mark: 5 point). The correct answer rates for handwashing and gloving. cleaning patients' rooms. preventing sharp injury, preventing exposure to potential infectious agents, home care bag technique were 84.5% 86.4% 70.7% 65.3% 76.2% representatively. For the knowledge on the infection control principles to prevent catheter related infection, indwelling catheter related infection, tracheal tube related pneumonia. L-tube related infection, oxygen therapy related infection. and wound infection were 62.8% 27.8% 39.1% 87.8% 76.5% 80.5% representatively. The correct answer rates varied depending upon the educational institutes (p< = .0001), educational levels (p= .001), workplaces (p<.0001), and the experience of infection control education (p= .001). Considering these results. a standardized curriculum must be developed and implemented after analyzing the existing infection control curricula of the home care education institutes. and guide books for infection control in home care should be developed and distributed. In addition. continuous infection control education be provided to the home care nurses through reeducation so they can acquire new knowledge needed for carrying out infection control activities effectively.

• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
• /
• pp.12-12
• /
• 1982

기관절개술은 1649년 Fienus가 처음으로 호흡곤란 환자에게 시술하고 Tracheotomy라 명명한 이래 기도확보, 기관 및 기관지로 부터 분비물 제거 및 산소공급을 목적으로 이용되어 많은 생명을 구하고 있다. 그러나 기관절개술후 성문하부의 협착, 기관연화, 기관절개공주위의 육아조직, 기관점막의 부종, 정신적인 의존 및 제 1기관륜 상부의 절개등으로 인한기관 Cannula 발거곤란증이 수반되기도 한다. 저자들은 1980년 4월 산업재해로 인한 두개내혈종 및 다발성늑골골절등으로 진단되어 타종합병원에서 개두술과 기관절개술을 받은 21세 남자환자에서 기관 Cannula 발거곤란증을 경험하였기에 중간보고하는 바이다. 1981년 11월 본원 이비인후과에 전원시 간접후두경 검사상 성대 및 가성대에 심한 부종이 있었으며 성대는 부정중위로 고정되어 있었고 기관지경검사상 성문하부에 협착이 인지되어 Jackson 식도 Bougie를 이용하여 3차에 걸쳐 Bougination으로 기관확장을 시도하였으나 효과가 없었다. 1981년 2월 협착부위의 기관륜과 윤상연골에 수직절개를 한 후 직경 1. 2cm의 Teflon tube를 협착부위에 삽입하고 9개월간 유치시킨 후 제거하고 Corking을 하여 현재 양호한 경과를 취하고 있다.

• Journal of Chest Surgery
• /
• 제30권4호
• /
• pp.453-456
• /
• 1997

기관삽관 및 인공호흡으로 발생하는 후천성 기관식도루는 드물고, 치료하기 힘든 질환이다. 57세 여자 환자로 교통사고후 장기간의 기관상관 및 기관절개 관 상관을 하고있던 환자로, 지속적인 흉인 있어 시행한 식도조영술과 기관지 내시경 검사에서 성문하 협착이 동반된 기관식도루로 진단되 었 다. 수술은 기관식도루 절제 후 4-0 vicryl로 두층으로 식도를 봉합하였으며, 4-0 PDS로 기관을 봉합였 고, 기관과 식도사이 에 흉골설골근(sternohyoid muscle)을 거치 시켜 재발을 방지하였다. T-자관을 기존 의 기 관절개술 부위 에 거치 하여 좁아진 부위가 내경을 유지할 수 있도록 할 뿐아니라 기 관내 분비물 흡 인제거를 용이하게 하였다. 환자는 술후 14일째 T-자관 제거하였으며 이후 좋은 경과를 보이고 있다.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제18권5호
• /
• pp.301-304
• /
• 2018

Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received $50{\mu}g$ of fentanyl 2-3 times (total $2.2-2.3{\mu}g/kg$) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1-4 times (total 0.02-0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.

• 대한후두음성언어의학회지
• /
• 제27권2호
• /
• pp.122-125
• /
• 2016

Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

• Journal of Medicine and Life Science
• /
• 제17권1호
• /
• pp.16-20
• /
• 2020

Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 mL of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed a completely collapsed left lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 mL of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient's vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11^th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that treatment strategy should be decided upon individually based on the patient's condition and clinical course of the disease.