• 제목/요약/키워드: pneumonia

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Implications of Emphysema and Lung Function for the Development of Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

  • Hong, Yoonki;Lee, Jae Seung;Yoo, Kwang Ha;Lee, Ji-Hyun;Kim, Woo Jin;Lim, Seong Yong;Rhee, Chin Kook;Lee, Sang-Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • 제79권2호
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    • pp.91-97
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    • 2016
  • Background: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. Methods: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. Results: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second ($FEV_1$, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator $FEV_1$: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). Conclusion: Emphysema severity measured by CT and post-bronchodilator $FEV_1$ are important risk factors for the development of pneumonia in COPD.

돼지의 마이코플라즈마성 폐렴과 경제형질간의 상관관계 연구 (The Relationships Between Mycoplasmic Pneumonia and Production Traits in Pigs)

  • 유임종;오형길;박병석;이하복;이종관;전병국;김나래;이준헌
    • Journal of Animal Science and Technology
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    • 제50권4호
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    • pp.437-444
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    • 2008
  • 임상적, 경제적으로 매우 중요한 돼지의 질병중 하나인 폐렴이 주요 경제형질과 어떠한 상관관계를 가지는지 조사하기 위하여 충남 홍성에서 도축된 돼지 총 6,362개체를 본 연구에 이용하였다. 폐렴은 진행정도에 따라 4단계로 분류하였으며 생산된 비육돈의 도체중, 등지방 두께, 육질, 규격, 삼겹살 두께를 측정하여 폐렴질병과 형질과의 연관성을 비교 분석하였다. 그 결과 폐렴의 정도가 증가함에 따라 도체중이 유의적으로 감소함을 알 수 있다(P<0.01). 등지방두께와 각 폐렴 단계별 증상간의 상관관계를 보면 등지방 두께는 폐렴 중증과 폐 농양간의 유의적인 차이는 보이지 않으나 폐렴 경증 단계와는 매우 높은 유의성이 있는 것으로 나타났다(P<0.01). 삼겹살두께와 각 폐렴 증상간의 상관관계를 보면 삼겹살 두께에서 정상과 경증, 중증, 농양 간에 유의적인 차이가 존재하나(P<0.01) 경증, 중증, 농양 간에는 차이를 보이지 않음을 확인할 수 있었다. 육질등급 출현율과 각 폐렴 증상간의 상관관계를 보면 정상과 경증, 중증 간에 유의적인 차이가 존재함을 확인할 수 있었다(P<0.01). 이는 폐렴의 정도가 심해짐에 따라 육질이 나빠지는 것을 알 수 있으며 폐렴이 규격 육질등급 출현율에 큰 영향을 미친다는 것을 알 수 있다. 규격등급 출현율과 각 폐렴 증상간의 상관관계를 보면 정상과 폐 농양 간에는 유의적인 차이를 발견할 수 없었으나 정상과 경증 및 중증 간에는 규격등급 출현율에서 유의적인 차이가 있음을 알 수 있었다(P<0.01). 이는 폐렴의 단계에 따라 도체의 규격등급 출현율에도 크게 영향을 미치고 있다는 것을 알 수 있다. 본 연구를 통하여 폐렴증상이 심해질수록 돼지의 주요 경제적 형질이 저하된다는 것을 확인하였으며 경제적 손실을 방지하기 위해서는 농가에서 폐렴이 발생하지 않도록 지속적인 관찰과 예방이 필요함을 알 수 있다.

기계호흡기 관련 폐렴환자의 정량적 배양에 있어서 Endotracheal Aspirates과 Protected Specimen Brush의 비교 관찰 (A Comparative Study of Endotracheal Aspirates and Protected Specimen Brush in the Quantitative Cultures of the Ventilator-Associated Pneumonia)

  • 류경렬;김민구;김기량;정호경;박영호;강병선;김호철;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제42권5호
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    • pp.737-743
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    • 1995
  • 연구배경: 기계호흡을 하고 있는 환자에서 폐렴은 흔히 일어나는 병원 감염이며 사망률도 높은 것으로 알려져 있으나 임상적인 폐렴 진단 기준이나 일반적으로 시행하는 객담의 정성배양법은 폐렴 진단에 오류가 많기 때문에 PSB를 이용한 정량배양법이 진단에 이용되고 있으나, PSB를 쉽게 이용할 수 없는 경우가 있어 비교적 용이하게 이용할 수 있는 EA의 정량배양의 진단적 가치에 대하여 연구하였다. 방법: 72시간 이상 기계호흡을 하고 있는 환자중 임상적으로 폐렴이 의심되는 환자 10명과, 대조군 5명을 대상으로 EA와 PSB를 이용하여 추출한 객담을 정량 배양하였다. 결과: EA와 PSB의 정량배양에서 폐렴의 진단 기준을 각각 $10^5cfu/ml$, $10^3cfu/ml$으로 정할때 PSB에서 민감도 70%, 특이도 80%, 양성예측치 88%, 음정예측치 57%, 정확도 73%, EA에서 민감도 70%, 특이도 60%, 양성예측치 78%, 음성예측치 50%, 정확도 67%였다. 결론: 저자들의 조사결과 기계호흡을 하는 환자의 폐렴진단에서 객담의 정량배양시 cut-off point를 EA에서 $10^5cfu/ml$ 이상 배양된 경우로 정할때, 민감도 70%, 특이도 60%, 양성예측도 78%로서 특이도가 EA 보다 높은 PSB를 대치하지는 못하지만 기관지 내시경을 사용할 수 없는 환자에서 유용하리라고 추측되나 더 많은 연구가 필요하리라 사료된다.

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약물중독 환자에서 Neutrophil Lymphocyte Ratio의 흡인성폐렴 발생 예측인자로서의 고찰 (Neutrophil-to-lymphocyte Ratio as A Predictor of Aspiration Pneumonia in Drug Intoxication Patients)

  • 이정범;이선화;윤성종;류석용;최승운;김혜진;강태경;오성찬;조석진;서범석
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.61-67
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    • 2018
  • Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

급성 호흡부전이 동반된 마이코플라즈마 폐렴 1예 (A Case of Mycoplasma Pneumonia Complicated with Acute Respiratory Failure)

  • 장병익;김형일;김성숙;이충기;정진홍;이관호;심봉섭;이현우
    • Tuberculosis and Respiratory Diseases
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    • 제39권2호
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    • pp.194-198
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    • 1992
  • Mycoplasma pneumoniae produces illness in man ranging from mild upper respiratory tract infection to severe bronchitis and pneumonia. We experienced a case of mycoplasma pneumonia complicated with acute respiratory failure, cold agglutinin hemolytic anemia, pleural effusion, Raynaud's phenominon and hepatitis in 27-year-old female. She was diagnosed as having mycoplasma pneumonia by detecting mycoplasma antibody and cold agglutinin test and treated effectively with erythromycin.

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흉부 X-선상 속립성 결핵과 유사한 양상을 보인 Mycoplasma 폐렴에서 ARDS로 진행된 1예 (A case of mycoplasma pneumonia which progressed to ARDS)

  • 김의숙;이원석;이강룡;이정아;백영주;이광섭;선우인철;김대하;장지정
    • Tuberculosis and Respiratory Diseases
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    • 제43권4호
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    • pp.645-650
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    • 1996
  • Mycoplasma Pneumonia is a main cause of primary atypical pneumonia and may present in a variety of ways. One auther has stated that the infiltrate is of a lobar segmental type, while others have found the infiltrates to be mainly reticular or interstitial. We experienced a case of mycoplasama pneumonia, which progressed to ARDS pattern rapidly an6 recovered completely after ventilator care.

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A Case of Organizing Pneumonia Associated with FOLFIRI Chemotherapy

  • Lee, Yoon Jeong;Kim, Jun-Hyun;Kim, Sun Woong;Kang, Won Chan;Kim, Soo Jung;Kim, Ji Hye;Kim, Sun Jong
    • Tuberculosis and Respiratory Diseases
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    • 제77권6호
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    • pp.262-265
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    • 2014
  • The combination chemotherapy of irinotecan with 5-fluorouracil and leucovorin (FOLFIRI regimen) was recently proven to be beneficial in patients with advanced colorectal cancer. Pulmonary toxicity is very rare in adverse effects of irinotecan. No case of organizing pneumonia (also known as bronchiolitis obliterans organizing pneumonia) associated with FOLFIRI chemotherapy has been reported. We experienced a case of a 62-year-old man who presented persistent dry cough and progressive dyspnea after receiving chemotherapy with FOLFIRI regimen. After surgical lung biopsy, the patient was diagnosed with FOLFIRI chemotherapy-induced organizing pneumonia which was successfully treated with steroid therapy.

Causes of Transfer of Neonates (Born after ≥34 Weeks of Gestation) to the Neonatal Intensive Care Unit Owing to Respiratory Distress and their Clinical Features

  • Jung, Yu Jin
    • 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.

담낭염과 폐렴을 동반한 전염성 단핵구증 1례 (A Case of Thickened Gallbladder Wall and Pneumonia in a Child with Infectious Mononucleosis)

  • 김현수;김형석;신영규;은백린;박상희;차상훈
    • Pediatric Infection and Vaccine
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    • 제4권1호
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    • pp.167-173
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    • 1997
  • Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

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