• Title/Summary/Keyword: cause of distress

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A Case of Miliary Tuberculosis Misdiagnosed as Pneumonia and ARDS Due to the Transient Improvement after Intravenous Injection of Levofloxacin (폐렴, 급성호흡곤란증후군으로 오인되어 Levofloxacin 투여 후 호전되어 진단이 지연된 속립성 결핵 1예)

  • Lee, Go Eun;Cho, Young Jun;Cho, Hyun Min;Son, Ji Woong;Choi, Eu Gene;Na, Moon Jun;Kwon, Sun Jung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.236-240
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    • 2009
  • Miliary tuberculosis is quite a rare but serious cause of acute respiratory distress syndrome (ARDS). Therefore, the early detection of military tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. We report a case of military tuberculosis mimicking ARDS. A female patient was admitted due to repeated fever and dyspnea. The initial chest CT scan showed diffuse ground glass opacity, without a miliary pattern. The case was considered to be ARDS caused by pneumonia. She showed improvement after being treated with levofloxacin. However, she was re-admitted with fever seven days after discharge. The follow up chest CT scan showed micronodules in both lungs. An open lung biopsy confirmed the diagnosis of military tuberculosis.

The Psychological Impacts of Chemical, Biological and Radiological Disasters (화학, 생물, 방사능 사고의 정신적 영향)

  • Lee, Da Young;Sim, Minyoung
    • Anxiety and mood
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    • v.13 no.1
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    • pp.1-9
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    • 2017
  • We reviewed the scientific literature on psychological effects of Chemical, Biological, Radiological, Nuclear, Explosive (CBRNE) disaster, which is one of the biggest threat to modern society. CBRNE disaster has the potential to cause specific physical symptoms and psychological distress in victims ; moreover, various toxic symptoms and carcinogenesis/mutation would be an important issue. Bioterrorism can cause localized outbreaks of infectious disease or pandemic disaster. Somatization as well as posttraumatic stress symptoms and depression are the characteristic psychological symptoms in CBRNE disaster's victims. CBRNE disasters could lead to large-scale public fear and social chaos due to the difficulties involved in verifying the extent of exposure and unfamiliar area to the common people. In the evacuation process, problems associated with adjustment and conflict between victims and residents should be considered.

A Case of Vivax Malaria Complicated by Adult Respiratory Distress Syndrome and Successful Management with Extracorporeal Membrane Oxygenation

  • Lee, Hyun-Jung;Baek, Ji-Hyeon;Chae, Myoung-Hun;Joo, Hoyeon;Lee, Jin-Soo;Chung, Moon-Hyun;Park, Yun-Kyu;Kim, Joung-Teak
    • Parasites, Hosts and Diseases
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    • v.51 no.5
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    • pp.551-555
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    • 2013
  • Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial

  • Sabzehei, Mohammad Kazem;Basiri, Behnaz;Shokouhi, Maryam;Ghahremani, Sajad;Moradi, Ali
    • Clinical and Experimental Pediatrics
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    • v.65 no.4
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    • pp.188-193
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    • 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.

A Study for Optimum Joint Spacing in Jointed Concrete Pavement (줄눈 콘크리트포장의 적정 줄눈간격에 대한 연구)

  • Chon, Beom-Jun;Lee, Seung-Woo
    • International Journal of Highway Engineering
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    • v.7 no.4 s.26
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    • pp.69-77
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    • 2005
  • Joint spacing is a potent influence in increasing the long term performance of jointed concrete pavement slabs through the control of tensile stress, sealant failure and Load Transfer Efficiency (LTE). Internal Joint Spacing is an empirical and fixed method therefore this study will present the optimum joint spacing considerations depending on various climactic conditions. Calculating the optimum joint spacing eliminates random cracking due to the effect of the environmental loads such as the early behavior of drying shrinkage and heat hydration. Optimum joint spacing is calculated so as not to cause pavement distress by the deterioration of LTE by long term pavement movement. This study shows that the provisional joint spacing is 6-8m. Pavement Distress Prediction Models show that pavement distress has no effect on joint spacing of 8m.

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A literature study of pediatric pneumonia in traditional chinese medicine (소아폐렴(小兒肺炎)의 한의학적(韓醫學的) 연구(硏究)에 대한 고찰(考察) -중의학(中醫學) 문헌(文獻)을 중심(中心)으로-)

  • Kim, Jang-Hyun;Kwon, Hyuk-Ran
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.1
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    • pp.99-115
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    • 2003
  • Pneumonia is an acute or recurrent infection of the parenchyma of the lung causing cough, fever, and respiratory distress. Pneumonia was named 'Feiyanchuansou(肺炎喘嗽)' in chinese medicine. This study was progressed for oriental medical treatment for pediatric pneumonia in china. The purpose of this study is current oriental medical approach to pediatric pneumonia In this study, the authors tried to figure out the cause of the pediatric pneumonia and its treatment and came to the conclusion as follows: 1. The study for pediatric pneumonia consists of basic, clinical and experimental study. 2. Basic study consists of etiology and pathogenesis(病因病耭), the rule of treatment(治療原則) and method of treatment(治法). 3. Clinical study consists of symptoms-based treatment(辨證論治), adequate prescription treatment(專病專方), acupuncture(鍼灸治療), and western diagnosis based treatment. 4. The majority of experimental study was pharmacology that consists of antiviral and antibacterial effect, removing heat(淸熱), releasing pulmonary qi(宣肺), dissipating phlegm(化痰).

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A plunging ranula in a child with holoprosencephaly: a case of unique pathophysiology and difficult airway management

  • Watanabe, Takuma;Yokoyama, Atsushi;Shimizu, Satoshi;Bessho, Kazuhisa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.4
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    • pp.232-236
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    • 2022
  • A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

Barotraumatic Rupture of The Esophagus -A Case Report- (압력 상해에 의한 식도파열 -1례보고-)

  • 이해영
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.331-334
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    • 1994
  • Pneumatic rupture is a rare cause of esophageal injury, as evidenced by only 19 cases reported in the literature. We experienced one case of esophageal rupture due to bursting of a truck inner tube. The patient, who was a 45-year old male, had severe chest pain, respiratory distress, flushing in the face and neck, and subcutaneous emphysema after tire explosion. Three days after the incident, a diagnosis of rupture of the thoracic esophagus was established by esophagogram using water soluble contrast media, and then emergency operation was done. The operation involved mediastinal and thoracic drainage and resection of the esophagus combined with cervical esophagostomy and feeding gastrostomy. On the 105th day after the operation, cervical esophagogastrostomy via substernal route was performed. The patient was successfully treated with the staged operations. As in the other reported cases, the injury was located in the lower one third of the esophagus. Four main characteristics of the clinical signs of pneumatic rupture are 1] wounds or burns to the face or mouth, 2] chest pain or epigastric pain, 3] subcutaneous emphysema, and 4] respiratory distress. We emphasize that the high index of suspicion of esophageal rupture is very important in diagnosis and that diagnosis should be based on the same findings common to other forms of esophageal injury.

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Acute Respiratory Distress due to Rapid Tranquilization in a Bipolar Patient with Sleep Apnea (수면 무호흡증이 있는 양극성 장애 환자에서 급속 정온요법으로 인해 발생한 급성 호흡 장애)

  • Ham, Byung-Joo;Seo, Yong-Jin;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.144-147
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    • 2001
  • Chemical restraint or "rapid tranquilization" is another option in treating patients who are a danger to themselves or others and struggle violently once physically restrained. The most commonly used drugs are benzodiazepines and antipsychotics. The use of benzodiazepines, either alone or in combination with high potency neuroleptics, has increased in recent years. Benzodiazepines are extremely safe but may cause respiratory depression and hypotension. Respiratory depression is more likely with intravenous administration, therefore these medications should be given slowly and titrated to the desired effect. Special care should be taken when sedating patients who are under the influence of alcohol or narcotics and are sleep apneic patients. This report deals with a case of respiratory distress in a patient with sleep apnea syndrome after the rapid tranqulization. All patients receiving chemical restraint must be carefully monitored. For critically ill patients who require sedation or chemical restraint, the constant attendance of a physician may be warranted.

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The Effects of Open Endotracheal Suctioning(ETS) and Close ETS on Oxygen Saturation and Heart Rate in Premature Infants with Respiratory Distress Syndrome (개방형과 폐쇄형 기관지 흡인술이 호흡곤란 미숙아의 산소포화도와 심박동수에 미치는 영향에 대한 비교연구)

  • 김미순;안영미;박인옥;최숙자;유미영
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.529-539
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    • 1998
  • Prematurity is the main cause for respiratory distress syndrome (RDS) in neonates. The goal in the treatment of RDS is to maintain respiration with adequate oxygenation. ETS needs to be performed to remove lung secretions in the ventilated premature infants with RDS. Oxygen saturation(SpO$_2$) and heart rate(HR) were compared in 22 premature infants with RDS using two types of ETS : open ETS versus close ETS. The results showed there was no significant difference in the SpO$_2$ and HR responses between open ETS and close ETS. The SpO$_2$ and HR returned to the baseline within 1 minute after suctioning. But in some case, there was a significantly greater incidence in the decrease of SpO$_2$ below 90% occured in the open ETS than in the close ETS. It implies that closed ETS may be beneficial to the premature infants who tend to develop desaturation easily.

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