• 제목/요약/키워드: acute upper respiratory infection

검색결과 55건 처리시간 0.03초

신생아집중치료실에서의 급성 호흡기 감염-바이러스의 검출 및 respiratory syncytial virus 감염의 임상적 특징 (Acute Respiratory Infections in the Neonatal Intensive Care Unit: Isolation of Viruses and the Characteristics of Respiratory Syncytial Virus Infection)

  • 박선희;조혜정;심소연;손동우;은병욱;선용한;차한;전인상
    • Neonatal Medicine
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    • 제16권2호
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    • pp.182-189
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    • 2009
  • 목 적 : 최근 multiplex RT-PCR의 개발로 급성 호흡기 감염에서 바이러스의 검출이 용이해졌다. 지금까지 respiratory syncytial virus (RSV)에 대한 연구는 많았지만 이전에 건강했던 신생아나 미숙아로 출생한 어린 영아에 대한 연구는 많지 않고 더욱이 이들에서의 다른 호흡기 바이러스에 대한 연구는 거의 없다. 저자들은 신생아집중치료실에 입원한 급성 호흡기 감염 환아를 대상으로 바이러스를 검출하고 다른 바이러스와 비교한 RSV 감염의 특성을 알아보고자 하였다. 방 법 : 신생아집중치료실에 급성 호흡기 감염으로 입원하여 multiplex RT-PCR을 시행한 환아를 대상으로 전향적 관찰 연구를 시행하였다. 모든 환아를 RSV군과 RSV가 검출되지 않은 No RSV 군으로 나누어 인구학적 특징과 임상양상 및 혈액검사와 흉부X-선 검사결과를 비교하였다. 결 과 : RSV 군은 23명(50%)이었다. Rhinovirus는 15.2%로 두 번째로 많이 검출되었다. RSV는 1월과 2월에, rhinovirus는 4월에 중점적으로 발생하였다. 중복감염 된 환아는 세 명(6.5%)이었다. 미숙아 수와 형제가 있거나 흡연에 노출 된 경우는 두 군간 차이가 없었으나 RSV 군에서 조리원 감염이 유의하게 많았다(60.9% vs. 21.7%, P=.007). RSV 군에서 No RSV 군에 비해 호흡곤란(34.8% vs. 8.7%, P=.032)과 폐렴(73.9% vs. 43.5%, P=.036)으로 입원한 환아가 많았고 산소 투여(52.5% vs. 13.0%, P=.005)와 금식(43.5% vs. 13.0%, P=.022)이 필요한 경우가 많았다. 우측상엽의 침윤도 RSV 군에서 많았다(56.5% vs. 8.7%, P=.001). 결 론 : 신생아나 미숙아로 출생했던 어린 영아는 RSV 뿐만 아니라 다른 다양한 호흡기 바이러스 감염으로 입원하게 된다. RSV 감염은 다른 감염에 비해 중증도가 높으므로 건강한 신생아에 대해서도 주의를 요하며 특히 조리원 등 밀집도가 높은 곳에서는 철저한 감염예방 관리가 필요하다.

서울시(市) 대기오염(大氣汚染)이 시민보건(市民保健)에 미치는 영향(影響)에 관(關)한 조사연구(調査硏究) (Epidemiological Study of Air Pollution and Its Effects on Health of Urban Population)

  • 정규철
    • Journal of Preventive Medicine and Public Health
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    • 제2권1호
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    • pp.5-22
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    • 1969
  • The urban population of our country is rapidly increasing due to many factors of social structure, and sociologists are predicting that the increase rate of the urban population will be over 50% in 1980's. Above all, the population of the capital city of Seoul, is at present more than four millions. Such centring of people in cities, together with the improvement of the standards of living, caused rapid increase in the amount of fuel consumption, and this consumption of fuels became one of the primary sources of the air pollution in cities. Moreover, the heavy traffic, construction of many tall buildings, and the increasing number of new factories due to the industrial development-all these are contributing to make the matter of air pollution worse and worse in the Metropolitan, whose geographical location is quite unfavorable considered from the view point of air pollution. Most homes in Seoul use briquet as fuel, while oils are used in tall buildings. The CO, $SO_2$, and smoke that come from burning of these fuels are a great threat to the health of the urban population. With the purpose of examining the influence of air pollution upon the public health, written inquiries were made upon respiratory diseases, and the carboxyhemoglobin saturation in the blood was measured to determine whether the air pollution may affect the health of the urban population. Method of Health Examination (1) Investigation of Respiratory Diseases Patients' records were examined to figure out the monthly ambulance rate of respiratory patients to the total number of patients treated. On the other hand, by using the questionnaire form approved by the Medical Research Council's Committee on Research into Chronic Bronchitis, investigators interviewed the examinees and inquired into the respiratory symptoms. (2) Measuring of Carboxyhemoglobin Saturation From the ear lobe of the examinees, with the use of the melangeur for the white blood cell counting, blood was taken, and after diluting it ten times with 0.1% $Na{2}CO_{3}$, again diulting it 20 times with 0.5% $Na_{2}\;CO_{3}$, its absorbancy was measured. The following results are obtained from the investigation. (1) It was found out that 7.7% of the total patients under treatment were suffering from upper respiratory infection, acute or chronic bronchitis, bronchial asthma, pulmonary emphysema and bronchiectasis. Of them all, patients with upper respiratory infection numbered the greatest with 4.8% and patients with acute or chronic bronchitis the next with 2.1%, and their monthly ambulance rate was high from December to February during the winter, and from April to May and from September to October during the changeable seasons. (2) The daily ambulance rate of respiratory patients, it was revealed, had a close connection with the concentration of $SO_2$ and CO in the air. (3) It was found out that men were more subject to respiratory disease than women, and both men and women were more liable to the diseases with the advancing of age. (4) People living at Choong-ku with the heavy traffic and in the industrial zones of Yeungdungpo had high frequency of respiratory symptoms. (5) Considered from the view point of occupations, high frequency was found among those without job, with jobs unknown, merchants and intdustrial workers, whose social status was rather low and traffic policemen who were always exposed to the exhaust gas of cars. As for women, the frequency was detected in the order of those from high to low, housewives who were exposed to briquet gas, women with jobs unknown, women without jobs, whose social status was low. (6) Ex-smokers rather than smokers, of both sexes, had higher frequency. As for men, heavy smokers had high frequency, while in women light smokers had rather high frequency which was presumed to be due to their average old age. (7) Men's average of carboxyhemoglobin saturation was 9.48%, while women's was 11.3%, higher than men's. (p<0.05). Age meant no difference in the case of men, but as for women, the saturation was remarkably high between the ages from 20 to 60. (8) No regional difference was detected in the carboxyhemoglobin saturation. (9) The carboxyhemoglobin saturation was found, in the case of men, in the order of office workers, traffic policemen, students, the unemployed, merchants and industrial workers, drivers; and as for women, the order was housewives, office workers, merchants and industrial workers. (10) No significant correlation was found between the carboxyhemoglobin saturation and the concentration of CO detected in kitchens, or between the carhoxyhemoglobin saturation and the passing of time after exposure to briquet gas. No difference of carboxyhemoglobin saturation was detected between smokers and non-smokers, and the degrees of smoking; only, significant negative correlation was found between the passing of time after smoking and the carboxyhemoglobin saturation. It is ture that air pollution causes or aggravates the respiratory diseases, increases the carboxyhemoglobin saturation in the blood, but what seems to be more hazardous to the health is the air polluted by the briquet gas in the kitchens and on-dol rooms rather than the atmospheric air pollution.

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폐동맥류를 동반한 만성 괴사성 침입성 폐 국균증 1예 (A Case of Chronic Necrotizing Pulmonary Aspergillosis with Pulmonary Artery Aneurysm)

  • 김휘종;정효영;김수희;윤지철;이종덕;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제49권1호
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    • pp.105-110
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    • 2000
  • 저자들은 객담, 기침, 발열과 호흡곤란을 보이고 단순 흉부촬영상 다발성 공동과 경변을 보이며 흉부 전산화 촬영과 폐동맥 혈관조영술상 폐 동맥류가 확인된 환자에서 폐 절제술후 만성 괴사성 침입성 폐 국균증으로 진단된 1예를 경험하였기에 이에 보고하는 바이다.

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균혈증을 동반한 비피막형 인플루엔자균에 의한 접형동 부비동염 소아 1례 (Isolated Sphenoid Sinusitis with Nontypeable Haemophilus influenzae Bacteremia in a Healthy Child)

  • 석민정;최규영;신새암;조기영
    • Pediatric Infection and Vaccine
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    • 제27권1호
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    • pp.62-68
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    • 2020
  • 급성 세균성 부비동염은 소아에서 흔하게 발생하는 질환 중 하나로, 바이러스성 상기도 감염 후 5-13%에서 동반하는 것으로 알려져 있다. 접형동에 국한된 부비동염이 발생할 확률은 모든 부비동염의 3% 미만이나 접형동의 구조적 특성상 주위 조직으로 감염이 전파되면 치명적일 수 있다. 비피막형 인플루엔자균(non-typeable Haemophilus influenzae[NTHi])은 급성 세균성 부비동염의 흔한 원인균이나 정상면역인 환아에서 균혈증으로 파급되는 경우는 매우 드물다. 저자들은 특별한 기저질환이 없는 소아가 발열과 두통으로 내원하여 균혈증을 동반한 NTHi에 의한 편측 접형동에 국한된 부비동염이 확인되어 항생제 및 수술적 치료로 호전된 예를 경험하여 보고하는 바이다.

울산 지역 소아청소년과 및 이비인후과에서의 항생제 처방 형태 (Outpatient Antibiotic Prescription by Pediatric and ENT Physicians in Ulsan City)

  • 김성철;박용철;김보금;남두현
    • 한국임상약학회지
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    • 제20권2호
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    • pp.145-150
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    • 2010
  • In order to investigate the antibiotic prescription pattern for upper respiratory infections (URI), the prescription sheets for outpatients from July 2008 to June 2009 were collected from 7 community pharmacies in Ulsan City, and the prescription pattern of Pediatric and ENT physicians was analyzed. The antibiotic prescription rates of Pediatric and ENT physicians were 63.8% and 61.7%, respectively. It was also observed that the oral antibiotic prescription was 95.6% in Pediatrics and 97.6% in ENT. The most favorable antibiotics by Pediatric physicians were penicillins (21.5%) penicillin-clavulanate (36.4%) and cephalosporins (16.5%), macrolides (11.6%), quinolones (3.5%), and nifuroxazide (3.5%). In case of ENT, the commonly prescribed antibiotics were also penicillin-clavulanate (47.6%), cephalosporins (31.6%), macrolides (11.9%) and sulfonamide (1.3%). The antibiotic combination rate was 7.6% in Peditrics and 1.9% in ENT, among antibiotic prescriptions. The combination of more than two oral antibiotics was examined as 66.8% in Pediatrics and 44.2% in ENT. The common oral antibiotic combination in Pediatrics was prescriptions of two ${\beta}$-lactam antibiotics (54.3%). Among them 83% was the combination of amoxicillin-clavulanate (7:1) and amoxicillin, which could be judged as antibiotic overuse. The next highly prescribed oral antibiotic combination was ${\beta}$-lactam/macrolide antibiotic combination probably for URI (11.3%) and ${\beta}$-lactam/nifuroxazide combination (10.0%) presumably for acute diarrhea. Comparatively the oral antibiotic combination prescribed by ENT physicians was negligible except one physician. In conclusion, the antibiotic over-prescription rate by antibiotic combination was much higher in Pediatrics than ENT, even though both clinical departments showed nealy the similar antibiotic prescription rates.

정보 공개에 따른 지역별 항생제 처방률 변이에 영향을 미치는 요인 - 전국 시군구 의원을 중심으로 - (The factors influencing variation by local areas in antibiotics prescription rate according to the public reporting)

  • 천유진;김창엽
    • 보건행정학회지
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    • 제22권3호
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    • pp.427-450
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    • 2012
  • Objectives : This study examined the factors influencing variation by local areas of antibiotics prescription rate in upper respiratory infections (URI) according to the public reporting. Methods : We used the National Health Insurance Claims Data which the clinics claimed for URI (Korean Standard Classification of Disease, J00 ~ J06) in ambulatory care. The period of analysis was from the first quarter (from January to March) of 2005 to the first quarter of 2007. The number of samples was total 242 local areas that included all clinics (N = 7,942), which prescribed antibiotics for URI in ambulatory care. Results : None of the demographic and socioeconomic characteristic indicators was statistically significant. Among the provider factors, An increase in number of doctors and the average annual antibiotics prescription rate (from 2003 to 2004) for URI by local area were significantly related to an increase of antibiotics prescription rate according to the public reporting. And an increase in number of pediatric clinics, the proportion of clinics less than 5 years since has opened and the average annual fluctuation of antibiotics prescription rate (from 2003 to 2005) were significantly related to a decrease in antibiotics prescription rate by local area according to the disclosure of information. Conclusions : According to the public reporting, the antibiotics prescription rate in clinics had decreased sharply. However, the reduction of antibiotic prescription rate varied in different local areas. The factors influencing variation by local areas in antibiotics prescription rate can be used for establishing effective strategies to reduce variation by region in antibiotics prescription rate.

A Case of Plastic Bronchitis Associated Influenza A Pneumonia Requiring ECMO Assistance

  • An, Hong Yul;Baek, Seung Min;Choi, Youn Young;Kim, You sun;Lee, Eui Jun;Choi, Yu Hyeon;Choi, Yun Jung;Suh, Dong In;Kwak, Jae Gun;Kim, Woong-Han;Park, June Dong
    • Pediatric Infection and Vaccine
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    • 제25권2호
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    • pp.101-106
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    • 2018
  • 6세 남아가 인플루엔자 A 바이러스 감염 이후 급성 호흡부전 상태에서 내원하였다. 기관 삽관 이후 인공 호흡 및 산화 질소공급에도 호흡성 산증 및 저산소증의 호전이 없어 내원 9시간 이후 체외막 산소 공급을 이용하여 호흡 보조를 시행하였다. 내원 12시간 이후 기관지경을 이용하여 우측 중간 기관지부터 상엽 구멍을 막고 있는 단단한 점액 마개를 제거하였다. 이후 환자는 신경계와 호흡기계 후유증 없이 퇴원하였다. 저자들은 플라스틱 기관지염으로 인한 급성 호흡 부전 상태의 환자에서 신속한 체외막 산소 공급 및 기관지경술의 처치를 시행함으로써 후유증 없이 치료한 사례를 보고한다.

Acute Disseminated Encephalomyelitis Presenting as Rhombencephalitis: An Atypical Case Presentation

  • Hwang, Joonseok;Lee, A Leum;Chang, Kee Hyun;Hong, Hyun Sook
    • Investigative Magnetic Resonance Imaging
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    • 제19권3호
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    • pp.186-190
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    • 2015
  • Acute disseminated encephalomyelitis (ADEM) is a demyelinating and inflammatory condition of the central nervous system, occurring predominantly in white matter. ADEM involving the rhombencephalon without affecting the white matter is very rare. Here, we present an unusual case of ADEM involving only the rhombencephalon in a 4-year-old Asian girl. The patient complained of pain in the right lower extremities, general weakness, ataxia, and dysarthria. The initial brain CT showed subtle ill-defined low-density lesions in the pons and medulla. On brain MRI, T2 high signal intensity (T2-HSI) lesions with mild swelling were present in the pons, both middle cerebellar peduncles, and the anterior medulla. The initial diagnosis was viral encephalitis involving the rhombencephalon. Curiously, a cerebrospinal fluid (CSF) study revealed no cellularity, and negative viral marker findings. Three weeks later, follow up brain MRI showed that the extent of the T2-HSI lesions in the brain stem had decreased. After reinvestigation, it was found that she had a prior history of upper respiratory infection. In this case, we report the very rare case of a patient showing isolated involvement of the rhombencephalon in ADEM, mimicking viral rhombencephalitis on CT and MR imaging. ADEM can involve unusual sites such as the rhombencephalon in isolation, without involvement of the white matter or deep gray matter and, therefore, should be considered even when it appears in unusual anatomical areas. Thorough history taking is important for making a correct diagnosis.

Overlap syndrome of Miller-Fisher syndrome/Pharyngeal-Cervical-Brachial variant-Guillain Barre Syndrome with anti-ganglioside complex antibodies

  • Lee, Suk-yoon;Oh, Seong-il;Huh, So-Young;Shin, Kyong Jin;Kim, Jong Kuk;Yoon, Byeol-A
    • Annals of Clinical Neurophysiology
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    • 제22권2호
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    • pp.112-116
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    • 2020
  • Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS) can present with overlapping features. A 56-year-old female developed ptosis and diplopia after an upper respiratory infection, and presented with facial palsy, dysarthria, brachial weakness, ataxia, and areflexia. Mild weakness of both legs appeared after a few days. Anti-ganglioside complex antibody were positive to IgG GM1/GQ1b and GQ1b/sulfatide antibodies. The present case suggests that the manifestation of overlap between MFS/PCB variants and GBS could be caused by antiganglioside complex antibodies.

삼출성 중이염에 대한 임상적 고찰 (A Clinical Study of Otitis Media with Effusion in the Oriental Medicine.)

  • 김윤범;채병윤
    • 한방안이비인후피부과학회지
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    • 제5권1호
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    • pp.133-142
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    • 1992
  • We analyzed clinical study in 47 patients, who had visited to the Dept. of Otolaryngology, Hospital of Oriental Medicine, Kyung Hee University to treat Otitis media with effesion from March, 1991 to February, 1992. The clinical etiology of O.M.E. was tubal occlusion, acute otitis, and allergy. The clinical symptoms were hearing loss, tinnitus, sneezing, coughing, Chun-I(纏耳), and BEE-Yeon(鼻淵) in the Oriental Medicine. The results were as follows. 1. There were 26 males ($55\%$) and 21 females ($45\%$) in sex. 2. The peak age at onset was 1-4 years old (11Cases). 3. Bilateral effusion was in $62\%$, and unilateral in $38\%$. 4. The etioloigic factors were upper respiratory infection 16 cases, Allergic rhinitis 13 cases, Sinusitis 8 cases, etc. 5. The most common chief complaint was hearing loss ($30\%$). 6. There was no significant difference between blood types in O.M.E., ( A type $30\%,\;B\;type\;25\%,\;AB\;type\;13\%,\;0\;type\;13\%$, Unknown recorded $9\%$ ). 7. $21\%$ patients prefered warm and the others cold 8. As for digestion, good was in 31 cases ($81\%$), and poor 9 cases ($19\%$). 9. Man-Hyung-Ja-San Extract was most used in treatments as $38\%$, O-Ryung-San $35\%$ in descending order. 10. As for treatment period, 14 cases were treated over 12 weeks, 9 cases below 1 week

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