• 제목/요약/키워드: respiratory symptoms

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미용 목적으로 Atelocollagen 주입 후에 발생한 미만성 폐포출혈과 간질성 폐렴 2례 (Diffuse Pulmonary Alveolar Hemorrhage and Interstitial Pneumonitis after Subcutaneous Injection of Atelocollagen for Cosmetic Purpose : Two Case Reports)

  • 고영춘;임성철;박경화;김정순;김규식;김유일;김영철;윤성호;이승일;박경옥
    • Tuberculosis and Respiratory Diseases
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    • 제56권3호
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    • pp.308-314
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    • 2004
  • 콜라겐은 실리콘에 비해 안전성이 높아 최근 들어 생체 대체조직 및 이식 재료로 사용이 증가되고 있으며 유전자 치료에서 전달물질로서 연구되고 있다. 콜라겐 주입술은 상대적으로 간단한 시술로 알려져 본 증례에서와 같이 무면허 의료시술자에 의한 주입술이 증가하고 있다. 저자들은 건강한 젊은 여성에서 atelocollagen을 주사 한 후에 발생한 미만성 폐포 출혈과 급성 간질성 폐렴 2예를 경험하였기에 문헌고찰과 함께 증례를 보고하는 바이다.

결핵과 호지킨 림프종이 액와부 림프절에 공존하였던 1예 (Coexistence of Hodgkin's Lymphoma and Tuberculosis in the Same Axillary Lymph Nodes)

  • 반우호;강현희;백명기;김재경;김현진;백인운;김은오;고선혜;이상학;문화식;민기옥
    • Tuberculosis and Respiratory Diseases
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    • 제70권4호
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    • pp.342-346
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    • 2011
  • Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.

레지오넬라 폐렴과 폐렴구균 폐렴 환자의 임상 양상에 대한 비교 (Comparative Study of Pneumonia Caused by Streptococcus pneumonia and Legionella pneumophila)

  • 류지원;송진우;최창민;오연목;이상도;김우성;김동순;김미나;심태선
    • Tuberculosis and Respiratory Diseases
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    • 제68권2호
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    • pp.74-79
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    • 2010
  • Background: Legionella pneumophila has been recognized as an important cause of pneumonia. However, limited data are available in the literature regarding legionella pneumonia in Korea. The objective of this study was to compare epidemiological data and clinical presentation of legionella pneumonia and pneumococcal pneumonia. Methods: We retrospectively compared clinical, radiological, and laboratory data, antimicrobial treatment, and treatment outcomes between 28 cases of legionella pneumonia and 56 cases of pneumococcal pneumonia. Diagnoses of both legionella and pneumococcal pneumonia were based on commercial urinary antigen tests. Results: Legionella pneumonia patients included 23 men and 5 women, with a mean age of 61.6 years (range 36~88). Fifteen were smokers and 26 had some underlying diseases. Legionella pneumonia occurred more frequently in healthcare-associated settings than pneumococcal pneumonia (42.9% vs 21.4%, respectively, p=0.040). There were no significant differences in clinical signs and symptoms. Compared to patients with pneumococcal pneumonia, patients with legionella pneumonia presented more frequently with anemia (39.3% vs 8.9%, p=0.001), increased C-reactive protein (57.1% vs 30.4%, p=0.018) and increased alkaline phosphatase (46.4% vs 16.1%, p=0.003). Also, legionella pneumonia patients more often showed pleural effusion on simple chest X-rays (50.0% vs 12.5%, p<0.001). Conclusion: Legionella pneumonia and pneumococcal pneumonia can not be distinguished by clinical manifestations alone. However, legionella pneumonia occurred as a healthcare-associated pneumonia more frequently and was more often associated with anemia and increased CRP and alkaline phosphatase levels.

A Case of Ischemic Colitis Associated with Paclitaxel Loaded Polymeric Micelle ($Genexol-PM^{(R)}$) Chemotherapy

  • Park, Choel-Kyu;Kang, Hyun-Wook;Kim, Tae-Ok;Ki, Ho-Seok;Kim, Eun-Young;Ban, Hee-Jung;Yoon, Byeong-Kab;Oh, In-Jae;Choi, Yoo-Deok;Kwon, Yong-Soo;Kim, Yoo-Il;Lim, Sung-Chul;Kim, Young-Chul;Kim, Kyu-Sik
    • Tuberculosis and Respiratory Diseases
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    • 제69권2호
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    • pp.115-118
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    • 2010
  • Paclitaxel has been widely used for treating many solid tumors. Although colonic toxicity is an unusual complication of paclitaxel-based chemotherapy, the reported toxicities include pseudomembranous colitis, neutropenic enterocolitis and on rare occasions ischemic colitis. $Genexol-PM^{(R)}$, which is a recently developed cremophor-free, polymeric micelle-formulated paclitaxel, has shown a more potent antitumor effect because it can increase the usual dose of paclitaxel due to that $Genexol-PM^{(R)}$ does not include the toxic cremophor compound. We report here on a case of a 57-year-old man with advanced non-small cell lung cancer and who developed ischemic colitis after chemotherapy with $Genexol-PM^{(R)}$ and cisplatin. He complained of hematochezia with abdominal pain on the left lower quadrant. Colonoscopy revealed diffuse mucosal hemorrhage and edema from the sigmoid colon to the splenic flexure. After bowel rest, he recovered from his symptoms and the follow-up colonoscopic findings showed that the mucosa was healing. Since then, he was treated with pemetrexed monotherapy instead of a paclitaxel compound and platinum.

A Case of Occupational Hypersensitivity Pneumonitis Associated with Trichloroethylene

  • Jae, Young;Hwang, Eu Dong;Leem, Ah Young;Kang, Beo Deul;Chang, Soo Yun;Kim, Ho Keun;Park, In Kyu;Kim, Song Yee;Kim, Eun Young;Jung, Ji Ye;Kang, Young Ae;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Chung, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • 제76권2호
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    • pp.75-79
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    • 2014
  • Trichloroethylene (TCE) is a toxic chemical commonly used as a degreasing agent, and it is usually found in a colorless or blue liquid form. TCE has a sweet, chloroform-like odor, and this volatile chlorinated organic chemical can cause toxic hepatitis, neurophysiological disorders, skin disorders, and hypersensitivity syndromes. However, the hypersensitivity pneumonitis (HP) attributed to TCE has rarely been reported. We hereby describe a case of HP associated with TCE in a 29-year-old man who was employed as a lead welder at a computer repair center. He was installing the capacitors on computer chip boards and had been wiped down with TCE. He was admitted to our hospital with complaints of dry coughs, night sweats, and weight losses for the past two months. HP due to TCE exposure was being suspected due to his occupational history, and the results of a video-associated thoracoscopic biopsy confirmed the suspicions. Symptoms have resolved after the steroid pulse therapy and his occupational change. TCE should be taken into consideration as a potential trigger of HP. Early recognition and avoidance of the TCE exposure in the future is important for the treatment of TCE induced HP.

미세먼지 유도 기도염증에 대한 배암차즈기 추출물의 호흡기 보호 효과 (Respiratory Protective Effect of Salvia plebeia R. Br. Extracts against Ambient Particulate Matter-induced Airway Inflammation)

  • 송형우;지건영;김복규;양원경;한창균;신한재;박양춘;황지숙;강형식;김승형
    • 한국약용작물학회지
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    • 제25권5호
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    • pp.269-281
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    • 2017
  • Background: Small particles increase airway inflammation upon reaching the alveoli. Here, we investigated the protective or therapeutic effects of Salvia plebeia R. Br. (SP_R) extracts on airway inflammation. Methods and Results: To investigate the anti-inflammatory activity of SP_R extracts, we measured their inhibitory effect on the production of reactive oxygen species (ROS) expression of inflammatory mediators, and immune cell infiltration in MH-S alveolar macrophage cells and in the ambient particulate matter (APM)-exposed airway inflammation mice model. The SP_R extracts inhibited the production of ROS and expression of IL-4, IL-10, IL-15, and IL-17A mRNA in APM-stimulated MH-S cells. Oral administration of SP_R extracts suppressed APM-induced inflammatory symptoms, such as high alveolar wall thickness, excess collagen fibers, decreased mRNA expression of chemokines (Ccr9, Ccl5, Ccr3), inflammatory cytokines (IL-15, TNF-${\alpha}$), and IL-4 Th2 cytokine in the lung. The SP_R extracts also inhibited ROS production, granulocyte ($CD11b^+Gr-1^+$) infiltration, IL-17A, TNF-${\alpha}$, macrophage inflammatory protein (Mip-2), and chemokine (C-X-C motif) ligand 1 (Cxcl-1) production in the airway. The specific compounds in the SR-R extracts that mediate the anti-inflammatory effects were identified. Conclusions: In this study, SP_R extracts effectively inhibited airway inflammatory responses, such as ROS production and granulocyte infiltration into the airway, by regulating the expression of chemokines and inflammatory cytokines.

Clinical Characteristics and Prognostic Factors of Lung Cancer in Korea: A Pilot Study of Data from the Korean Nationwide Lung Cancer Registry

  • Kim, Ho Cheol;Jung, Chi Young;Cho, Deog Gon;Jeon, Jae Hyun;Lee, Jeong Eun;Ahn, Jin Seok;Kim, Seung Joon;Kim, Yeongdae;Kim, Young-Chul;Kim, Jung-Eun;Lee, Boram;Won, Young-Joo;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • 제82권2호
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    • pp.118-125
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    • 2019
  • Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인 (Guidelines for dental clinic infection prevention during COVID-19 pandemic)

  • 김진
    • 대한치과의료관리학회지
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    • 제8권1호
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

Direct Switch from Tiotropium to Indacaterol/Glycopyrronium in Chronic Obstructive Pulmonary Disease Patients in Korea

  • Lee, Sang Haak;Rhee, Chin Kook;Yoo, Kwangha;Park, Jeong Woong;Yong, Suk Joong;Kim, Jusang;Lee, Taehoon;Lim, Seong Yong;Lee, Ji-Hyun;Park, Hye Yun;Moon, Minyoung;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.96-104
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    • 2021
  • Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV1) ≥50%, post-bronchodilator FEV1/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV1 at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV1 versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

전자담배 관련 급성 폐 손상: 증례 보고 (Electronic Cigarette or Vaping Product Use-Associated Lung Injury: A Case Report)

  • 임지윤;남보다;황정화;김양기;오은선;이은지
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1581-1588
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    • 2021
  • 세계적으로 전자담배 사용의 급속한 증가와 함께 미국을 중심으로 전자담배와 관련된 사망보고들이 발생함에 따라 전자담배 관련 급성 폐 손상은 중요한 사회적 문제로 대두되었다. 이 증례 보고는 급성 호흡기 증상과 전자담배 흡연력이 있는 24세 남자 환자에서 전자담배 관련 급성 폐 손상을 진단한 국내 첫 사례이다. 흉부 CT에서 흉막하부 보존을 보이는 미만성간유리음영과 폐경화 및 중심소엽성 미세결절의 소견을 보여 전자담배 관련 폐 손상의 특징적 형태인 기질화폐렴과 미만성폐포손상에 해당하는 증례로 생각되었고, 검사실 소견에서 감염이 배제되고, 환자의 질병을 설명할 다른 원인이 없었다. 따라서, 임상 소견 및 부합하는 영상 소견으로 진단 기준을 충족하여, 다학제 진료를 통해 전자담배 관련 급성 폐 손상을 진단하였다. 이를 통해 영상의학과 의사들이 전자담배 관련 급성 폐 손상의 진단에 중요한 역할을 할 수 있을 것으로 생각된다.