• 제목/요약/키워드: pneumonia

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A Comparative Study of Nursing Home-Acquired Pneumonia with Community-Acquired Pneumonia

  • Cho, Young-Jae;Jung, Bong-Ki;Ahn, Joon-Seok
    • Tuberculosis and Respiratory Diseases
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    • 제70권3호
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    • pp.224-234
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    • 2011
  • Background: Little data is available regarding hospitalized patients with nursing home-acquired pneumonia (NHAP). This is unfortunate because there is an increasing number of elderly persons who are living in nursing homes in Korea. The aim of this study was to compare clinical characteristics and treatment responses of NHAP with community-acquired pneumonia (CAP). Methods: Patients with pneumonia who were admitted from eight nursing homes or from their own homes were enrolled between May 2007 and April 2009. Their clinical characteristics and treatment responses were reviewed retrospectively, and differences between the two groups were analyzed. Results: Of 110 Patients with pneumonia, 66 (60%) were from nursing homes and their median age was 84. In the NHAP group, functional performance status was significantly poorer, classical symptoms of pneumonia were less severe, and multi-lobe involvement (on chest radiographs) was more frequent than in the CAP group. Patients with NHAP more frequently showed lymphocytopenia, anemia, hypoalbuminemia, hypoxemia, and elevated blood urea nitrogen on admission. The mean CURB-65 score was 2.2 in the NHAP group, higher than 1.7 in the CAP group (p=0.004), and multi-drug resistant pathogens were also highly identified in NHAP group (39% vs. 10%, p=0.036). The mean duration of antibiotic therapy was greater for the NHAP (12.6 days) than for the CAP group (6.6 days) (p<0.001). The mortality rate was 23% in NHAP group, which was significantly higher than 5% in the CAP group (p=0.014). Conclusion: NHAP should be more intensively investigated because of the higher frequency of multi-drug resistant pathogens and mortality than the CAP.

유행성 마이코플라스마 폐렴에 대한 고찰 (Epidemic Pneumonia Caused by Mycoplasma Pneumoniae)

  • 변주남;김영철
    • Tuberculosis and Respiratory Diseases
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    • 제41권3호
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    • pp.289-298
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    • 1994
  • 연구배경 : 유행 질환인 마이코플라스마 폐렴의 일반적인 특성을 파악하는데 병원 자료의 이용에 제한점을 극복하고, 이 질환의 좀더 가까운 자연상을 알아보기 위하여 한 지역사회를 중심으로 관찰하였다. 방법 : 1993년 6월 부터 12월 까지 6개월 동안 전남의 한 해안지방에서 유행한 마이코플라스마 폐렴의 혈청학적으로 확진된 105예와 이에 더하여 같은 기간에 발생한 모든 폐렴으로서 확진되지는 않았으나, 의심되는 경우를 포함한 224명을 대상으로 하여 역학적 및 방사선 소견을 분석하였다. 결과 : 1) 남녀비는 1.5:1 이었다. 2) 연령분포는 5-9 세 사이가 57%로 평균 나이는 6.5세였고, 유행의 시간이 지남에 따라 시기별 평균연령은 낮아지는 추세를 보였다. 3) 인구 집단의 크기보다 집적성이 발생 빈도의 모형에 영향을 준다고 추정되었다. 4) 방사선 소견으로서는 단일 형태로서 간질성 폐렴이 가장 많았으며, 67예(74.5%)에서 한 엽에 국한된 병변을 보였다. 또한 대엽성 폐렴은 학동기에, 간질성 이나 미만성 폐렴은 유아기에 많았다. 결론 : 이상의 특성들은 향후 이 질환의 진단에 도움을 줄 수 있으리라 사료된다.

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Healthcare-Associated Pneumonia among Hospitalized Patients: Is It Different from Community Acquired Pneumonia?

  • Seong, Gil Myung;Kim, Miok;Lee, Jaechun;Lee, Jong Hoo;Jeong, Sun Young;Choi, Yunsuk;Kim, Woo Jeong
    • Tuberculosis and Respiratory Diseases
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    • 제76권2호
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    • pp.66-74
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    • 2014
  • Background: The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality. Methods: A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality. Results: A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167). Conclusion: HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.

내과계중환자실에서 인공호흡기관련 폐렴 번들 적용의 효과 (Impact of the Ventilator-associated Pneumonia Bundle in a Medical Intensive Care Unit)

  • 유송이;정재심;최상호;김미나
    • Journal of Korean Biological Nursing Science
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    • 제20권4호
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    • pp.205-213
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    • 2018
  • Purpose: The purpose of this study was to confirm the compliance of the application of a ventilator-associated pneumonia bundle and understand its effects on the decrease in the incidence of ventilator-associated pneumonia. Methods: This was a retrospective observational study with history control group design. Subjects were selected from January to June 2014, prior to the intervention using the ventilator-associated pneumonia bundle. Subjects were also selected from October 2014 to March 2015, 3 months after the intervention. The number of subjects was 112 before the intervention, and 107 after the intervention. Results: The number of nurses who followed the bundles increased from 8 out of 29 (27.6%) before the intervention to 19 out of 29 (65.5%) after the intervention (odd ratio= 4.99, confidence interval= 1.63-15.25, p= .004). There were 3 cases of ventilator-associated pneumonia before the intervention and 1 case after the intervention. The ventilator days were 2,143 days before the intervention and 2,232 days after the intervention. The ventilator-associated pneumonia rate of the 1,000 ventilator days was 1.40 before the intervention and decreased to 0.45 after the intervention. Conclusion: This study is meaningful, as there has been little research conducted regarding the application of the ventilator-associated pneumonia bundle in South Korea.

일개 대학 기숙사 거주 학생에 있어서 Chlamydophila pneumoniae의 혈청학적 감염률 조사 (Serological Investigation of the Infection Rate of Chlamydophila pneumonia among Residents of a Single University Dormitory)

  • 류재기;김현경;김동찬;이석준
    • 생명과학회지
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    • 제24권3호
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    • pp.318-322
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    • 2014
  • Chlamydophila pneumonia는 전 세계적으로 지역사회 폐렴을 유발하는 중요한 원인체이며 청소년과 젊은 성인에서는 경미한 폐렴 및 기관지염을 유발하나 면역력인 약한 소아나 기저 질환이 있는 노인층에서는 치명적인 질환을 일으킬 수 있다. 현재까지 국내에서 집단생활과 연관된 감염률에 대한 연구가 없는 실정이다. 본 연구에서는 미세면역형광법을 이용하여 대학 기숙사 거주자의 거주 기간에 따른 감염률을 조사하였다. C. pneumonia 과거 감염은 IgG 항체 역가 1:32 이상으로 하였다. 현재 감염은 IgG 항체 역가가 1:512 이상이거나, IgM 항체 역가가 1:16 이상이면서 류마토이드 인자 음성인 경우를 현재 감염으로 하였다. C. pneumonia 과거 감염률은 71.1%였으며, IgG와 IgM 항체를 이용한 현재 감염률은 각각 28.3%와 23.3%를 나타냈다. C. pneumoniae IgG 항체에 의한 과거 감염률은 집단생활이 1개월, 7개월, 13개월, 35개월 군에서 각각 50%, 71.4%, 66.7%, 89.5%로 나타났다. IgG 항체에 의한 현재 감염률은 1개월, 7개월, 13개월, 35개월 군에서 각각 50%, 28.6%, 33.3%, 10.5%를 보였으며 IgM 항체를 이용한 조사에서는 각각 41.7%, 28.6%, 26.7%, 5.3%를 나타냈다. 이상의 결과로 볼 때 집단생활자의 경우 C. pneumoniae 과거감염은 집단생활 경험의 개월 수가 많을수록 증가하였으며, 현재 감염율은 집단생활 초기에 증가하였다가 개월 수가 증가할수록 감소하였다. 본 연구는 C. pneumoniae의 집단시설 내의 혈청역학적 조사 및 예방법 연구에 있어 중요한 자료가 될 것으로 사료된다.

소양인(少陽人) 중풍환자(中風患者)에 병발된 Aspiration Pneumonia에 형방패독산(荊防敗毒散)을 투여한 증례(證例) (A clinical study of the treatment prescribed Hyoungbangpaedoksan for Aspiration Pneumonia concurred in Soyangin with stroke)

  • 심규헌;김정렬;김달래;한동윤
    • 사상체질의학회지
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    • 제15권2호
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    • pp.75-83
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    • 2003
  • Aspiration pneumonia is common complication in Stroke patient. A 60-years-old man was admitted because of cerebrovascular infarction. This patient had problem of aspiration pneumonia. Without Western medical treatment(Antibiotics), patient's symptoms, sign and laboratory findings were improved through Soyangin Hyoungbangpaedoksan treatment. So, we report it for the better treatment.

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임상가를 위한 특집 1 - 노년의 구강 질환과 호흡기 질환의 관계 (The Relationship between Oral Disease and Respiratory Disease in the Elderly)

  • 정진석;허석모
    • 대한치과의사협회지
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    • 제51권9호
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    • pp.494-500
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    • 2013
  • Recently, several researches indicated the relationship between oral condition and respiratory disease such as pneumonia and chronic obstructive pulmonary disease (COPD). Respiratory disease is known as common chronic disease in the elderly increasing mortality and morbidity. In this study, we have reviewed the association between oral disease and respiratory disease in the elderly. The related data were searched and collected from abroad and domestic studies. The studies included the randomized controlled clinical trials (RCTs), longitudinal, cohort, case-control, and systematic review studies. With the data from the studies, we concluded that poor oral hygiene or periodontal disease can influence the pneumonia in the elderly. Further studies will be needed to investigate the association between oral disease and COPD.

돼지의 Pneumocystis carinii 폐렴 증례 (Pneumocystis carinii pneumonia in pigs)

  • 정지열;김기승;김대용;김재훈
    • 대한수의학회지
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    • 제47권3호
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    • pp.321-324
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    • 2007
  • Pneumocystis (P.) carinii is an opportunistic fungal pathogen of many animal species and human, which can cause fatal pneumonia in immunocompromised individuals. Three 100-day-old pigs with progressive atrophy, anorexia and respiratory distress were submitted to the Cheju National University for diagnosis. Grossly, the lungs were enlarged with rubbery consistency. Histopathologically, the lungs were characterized by diffuse interstitial pneumonia with thickening of alveolar septa due to infiltration of macrophages and lymphocytes. Alveolar lumens were filled with a foamy eosinophilic proteinaceous material in which numerous punctiform organisms. The organisms were demonstrated as P. carinii by Grocott-methenamine-silver staining and immunohistochemistry in lungs of two pigs. In our best knowledge, this is believed to be the first report of P. carinii pneumonia in pigs in Korea.

지질성 폐렴의 외과적 치료 (Surgical Treatment of Lipoid Pneumonia - A case report -)

  • 이계선;정진악;금동윤;안정태;이재원;나문주;백만순
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.194-197
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    • 1999
  • 지질성 폐렴이란 폐포나 간질에 존재하는 지질에 대한 폐조직의 반응을 의미하며 내인성과 외인성으로 구분된다. 내인성은 지질이 폐실질에서 생성된 경우를 말하며 외인성은 지질을 흡인하거나 흡입한 경우를 말한다. 본 증례의 경우 53세 남자가 오한과 혈담을 주소로 내원하여 경피적 흉막 및 폐생검을 시행후 내인성 지질성폐렴 진단하에 좌하엽절제술 및 늑막박피술을 치험하였기에 보고하고자 한다.

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