• Title/Summary/Keyword: severe distress

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A Premature Newborn with Congenital Syphilis (미숙아에 발생한 선천성 매독 1 예)

  • Hwang, In-Ok;Lee, Eun-Sil
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.333-338
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    • 2007
  • A preterm newborn affected by congenital syphilis, born to mother not treated during pregnancy is described. The clinical picture was characterized by respiratory distress, cutaneous manifestations, massive hepatosplenomegaly, severe anemia, thrombocytopenia, disseminated intravascular coagulation syndrome and hypoalbuminemia. The patient was treated with daily injections of 190,500 units of crystalline penicillin G for 14 days. Premature infants with these symptoms and signs should be evaluated for congenital syphilis.

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A Case of Airway Obstruction Secondary to Neonatal Nasopharyngeal Dermoid Teratoma (신생아 호흡곤란을 유발한 비인강 기형종 1례)

  • 김민식;선동일;이정학;조승호
    • Korean Journal of Bronchoesophagology
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    • v.5 no.1
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    • pp.90-95
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    • 1999
  • Dermoids are rare disease which arise during embryogenesis. They are the most common variety of teratomas occurring in the head and neck region and most arsies in the nasopharynx or oropharynx. They are invariably benign and derived from only two germinal layers, ectoderm and mesoderm. They usually present as repiratory distress and swallowing difficulty at or soon after birth. Treatment consists of surgical resection. We recently experienced a case of a neonatal nasopharyngeal dermoid which led to severe airway obstruction and feeding difficulty and necessitated the endotracheal intubation.

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One Stage Repair of Traumatic Ventricular Septal Defect and Mitral Regurgitation (외상성 심실중격결손 및 승모판막 역류증의 일차 완전정복)

  • 이재원;송태승;제형곤;송명근
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1131-1134
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    • 1999
  • After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

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Iron storage disease (ISD) with concurrent hepatic lipidosis (HL) in a mynah (Gracula spp.)

  • Lee, So-Young;Yoo, Jong-Hyun;Park, Chul;Kang, Byeong-Teck;Kim, Dae-Young;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.48 no.4
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    • pp.489-492
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    • 2008
  • An 8-year-old male mynah (Gracula spp.) was presented for depression, anorexia, and respiratory distress. The patient's diet consisted of sponge cake and yogurt alone. Physical examination revealed high body condition score (4/5), abdominal distention, and severe orthopnea. Hepatomegaly was observed on abdominal radiographs. The patient died 4 h after presentation, and severe hepatomegaly was observed at necropsy. Based on histopathological findings, the bird was definitively diagnosed with iron storage disease with concurrent hepatic lipidosis.

High Flow Nasal Cannula Assisted Tracheostomy for Securing Airways in Patients with Acute Respiratory Distress Induced by Glottic Cancer (급성 호흡곤란이 발생한 성문암 환자에서 기도 확보를 위한 고유량 비강 캐뉼라 보조 기관절개술)

  • Hong, Seung Woo;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.31-34
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    • 2020
  • Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.

Leri-Weill dyschondrosteosis in a newborn presenting with respiratory failure due to severe micrognathia

  • Gang, Mi Hyeon;Lee, Jianne;Lee, Yong Wook;Shin, Ji Hye;Lim, Han Hyuk;Kim, Yoo-Mi;Chang, Mea-young
    • Journal of Genetic Medicine
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    • v.17 no.2
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    • pp.108-111
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    • 2020
  • Short stature homeobox-containing gene (SHOX) is a well-known causative gene for the short stature in Turner syndrome. The clinical manifestation of SHOX gene related disorders varies from SHOX haploinsufficiency, presenting with idiopathic short stature, disproportionate short stature, or Leri-Weill dyschondrosteosis (LWD) to recessive form of extreme dwarfism and limb deformity in Langer mesomelic dysplasia. LWD is usually diagnosed upon suspicion based on short stature and skeletal abnormalities, and it is rarely accompanied with respiratory failure in the neonatal period. Here, we report the case of a newborn infant with LWD presenting with severe micrognathia that caused respiratory distress, which was diagnosed using microarray testing. Even when the manifestation of Madelung deformity is not yet apparent, LWD should be considered as one of underlying diseases related to congenital micrognathia.

Therapeutic Role of Inhaled Nitric Oxide for Acute Respiratory Failure in the Early Phase of Trauma (외상환자의 초기 호흡 부전에 대한 흡입산화질소의 적용)

  • Kim, Byoung Sung;Kyoung, Kyu-Hyouck;Park, Hojong
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.104-107
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    • 2015
  • Purpose: Nitric oxide (NO) is a vasodilator and inhaled NO (iNO) is used in acute respiratory distress syndrome (ARDS) to improve alveolocapillary gas exchange. The mechanism to improve oxygenation is likely to redistribute blood flow from unventilated areas to ventilated areas. Though improvement of oxygenation, iNO therapy has not been shown to improve mortality and considered as only rescue therapy in severe hypoxemia. We conducted the study to investigate an efficacy of iNO in trauma patients with severe hypoxemia. Methods: We reviewed the trauma patients who underwent iNO therapy retrospectively from 2010 to 2014. Degree of hypoxemia was represented as $PaO_2/FiO_2$ ratio (PFR) and the severity of patient was represented with sequential organ failure assessment (SOFA) score. Patients were divided into the survivor group and non-survivor group according to the 28-day mortality. Results: A total of 20 patients were enrolled. The mortality of 28-day was 40%. There were no significant differences between survivor and non-survivor group in age, sex, severity of injury, PFR and SOFA score. There was significant difference in initiation time of iNO after injury (p=0.047). Maximum combinations of sensitivity and specificity for timing of iNO therapy were observed using cut-off of 3-day after injury with a sensitivity of 88% and specificity of 75%. Conclusion: Though iNO therapy does not influence the mortality, iNO therapy may decrease the mortality caused by respiratory failure in the early phase of trauma.

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A Case of Scrub Typhus with Acute Respiratory Distress Syndrome and Meningoencephalitis (급성 호흡곤란증후군과 수막뇌염을 동반한 쭈쭈가무시병 1예)

  • Han, Hye-Won;Choi, Young-Ki;Park, Mahn-Won;Park, Ho-Sung;Son, Dong-Kyun;Lo, Dae-Keun;Kim, Seung-Joon;Lee, Sook-Young;Kim, Young-Kyoon;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.283-287
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    • 2002
  • Scrub typhus is an acute, febrile disease of humans that is caused by Orientia Tsutsugamushi. It is transmitted through the bite of chiggers. The spectrum of the clinical severity for scrub typhus ranges from mild to severe with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. Severe pulmonary involvement e.g. acute respiratory distress syndrome(ARDS) and meningoencephalitis have rarely been observed since the introduction of specific antibiotic therapy. We experienced a case of scrub typhus manifested with ARDS and meningoencephalitis. The patient was treated with doxycycline, anticonvulsant and mechanical ventilator therapy.

Determinants of Poor Self-rated Health in Korean Adults With Diabetes

  • Lee, Hwi-Won;Song, Minkyo;Yang, Jae Jeong;Kang, Daehee
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.6
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    • pp.287-300
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    • 2015
  • Objectives: Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes. Methods: A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance. Results: We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio $[OR]_{\text{Frequent stress events}}$, 5.40; 95% confidence interval [CI], 4.63 to 6.29; $OR_{\text{Severe distress}}$, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants' medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A1c levels of 6.5% or more, and comorbidities, were other correlates of poor reported health. Conclusions: Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.

Critical Care Medicine (호흡기내과 의사를 위한 Respiratory Review of 2010)

  • Park, Jie-Hae;Chae, Jin-Nyeong;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.2
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    • pp.75-80
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    • 2010
  • The year of 2009~2010 brought a number of concepts and new ideas were evaluated with promising results. However, some studies that challenged many beliefs. In acute respiratory distress syndrome (ARDS), recent clinical studies took into consideration of pathophysiologic changes of respiratory system compliance. Meta-analysis of positive end-expiratory pressure trials showed survival benefit of high positive end-expiratory pressure in ARDS. Until now, prone positioning did not show survival benefit in patients with ARDS. Extracorporeal membrane oxygenation (ECMO) based management improved survival in patients with severe ARDS. ECMO can be a management option in severe ARDS. Sedation is a standard practice in critically ill patients needing mechanical ventilation. However, Danish group reported less sedation of critically ill patients receiving mechanical ventilation was associated with an increase in days without ventilation. Although this single center study has some limitations, the overall results are promising. Use of maximal sterile barrier precautions (mask, sterile gown, sterile gloves, and large sterile drapes) with chlorhexidine-impregnated dressing reduced central venous catheter related infection. Selective oropharyngeal decontamination (application of topical antibiotics in the oropharynx) reduced the mortality rate of an intensive care unit (ICU) population. Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial reported intensive glucose control increased mortality among adults in the ICU. Some of the results of above papers are promising. However, some ideas may need for more frequent individual assessment and increase the workload of ICU staffs. Before implementation of new practice in ICU, we should take into consideration of individual hospital situation including human and material resources.