• Title/Summary/Keyword: upper chest type

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COVID-19 in a 16-Year-Old Adolescent With Mucopolysaccharidosis Type II: Case Report and Review of Literature

  • Park, So Yun;Kim, Heung Sik;Chu, Mi Ae;Chung, Myeong-Hee;Kang, Seokjin
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.70-76
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    • 2022
  • Coronavirus disease 2019 (COVID-19) in patients with underlying diseases, is associated with high infection and mortality rates, which may result in acute respiratory distress syndrome and death. Mucopolysaccharidosis (MPS) type II is a progressive metabolic disorder that stems from cellular accumulation of the glycosaminoglycans, heparan, and dermatan sulfate. Upper and lower airway obstruction and restrictive pulmonary diseases are common complaints of patients with MPS, and respiratory infections of bacterial or viral origin could result in fatal outcomes. We report a case of COVID-19 in a 16-year-old adolescent with MPS type II, who had been treated with idursulfase since 5 years of age. Prior to infection, the patient's clinical history included developmental delays, abdominal distension, snoring, and facial dysmorphism. His primary complaints at the time of admission included rhinorrhea, cough, and sputum without fever or increased oxygen demand. His heart rate, respiratory rate, and oxygen saturation were within the normal biological reference intervals, and chest radiography revealed no signs of pneumonia. Consequently, supportive therapy and quarantine were recommended. The patient experienced an uneventful course of COVID-19 despite underlying MPS type II, which may be the result of an unfavorable host cell environment and changes in expression patterns of proteins involved in interactions with viral proteins. Moreover, elevated serum heparan sulfate in patients with MPS may compete with cell surface heparan sulfate, which is essential for successful interaction between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and the host cell surface, thereby protecting against intracellular penetration by SARS-CoV-2.

Survey on the Actual Wearing Conditions of Naval Duty Uniforms in Naval Vessels (해군 함상 근무복 개발을 위한 착용 실태 조사)

  • Lee, Hyo-Hyun;Shin, Sora;Lee, Joo-Young;Baek, Yoon Jeong
    • Fashion & Textile Research Journal
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    • v.17 no.4
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    • pp.646-656
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    • 2015
  • This study investigates the conditions of Korean naval duty and combat uniforms to develop a new design. Survey participants consisted of, 723 Sailors ($25.3{\pm}6.9yr$ in age, $43{\pm}53$ months in work experience, $174{\pm}6cm$ in height, $71{\pm}9kg$ in body mass) serving in the Korean Navy for over 12 months. The questionnaire consisted of 72 questions about anthropometric characteristics, preferred design, textiles, wear mobility, and subjective perceptions. The results showed that the preferred colors for future naval duty uniforms were blue in summer (69%) and black in winter (62%). Digital camouflage pattern (60%) and darker colors on the inside of shirt collar (87%) and the edge of sleeves (84%) were preferred. They favored more than one pocket on the upper arm and chest of the shirts (58%), narrower width around pant legs and hems than the current clothing (63%), self-controlled elastic waist (55%) and no cargo type pocket on the pants (45%). There were requirements to alleviate excessive heat stress in summer and to protect from the cold and wind in winter. Wrinkle-free (85%), anti-bacterial (78%), water-proof (75%), oil-proof (90%), and elastic (67%) textiles were preferred for Korean navy uniforms. These results will be applied to develop the next generation Korean navy uniforms.

Surgical Treatment of Left Subclavian Aneurysm -A case report- (Subclavian artery 의 동맥류 -1예 수술 경험-)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Khil Rho;Kim, Song Myung
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.245-250
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    • 1976
  • A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

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The surgical treatment of bronchiectasis (기관지확장증의 외과적 치료)

  • 한승세
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.456-464
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    • 1984
  • Since the advent of potent chemotherapy, the incidence and severity of bronchiectasis have been on the decrease. Up to date, however, the medical treatment of bronchiectasis has not given us much satisfaction. Our purpose here is to show our experiences with pulmonary resections of bronchiectasis to clarify its surgical results and define its surgical indications. Sixty-five patients with bronchiectasis, treated surgically from January 1973 to December, 1982 at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, were given clinical assessment. Of the 65 patients involved in the series, 49 were male and 16, female. The patients ranged from 8 to 51 in ages, with 59 cases [91%] between 10 and 39 years old. The prominent clinical features were as follows: cough [88%], sputum production [78%], recurrent upper respiratory infection [51%], and frequent hemoptysis [32%]. The past history of the patients included measles 29%, whooping cough 14%, pulmonary tuberculosis 12%, and pneumonia or bronchitis 12%. The cylindrical type of the bronchiectasis was found to be most common, accounting for 43% of the cases. The operations were performed on the left lung in 52 cases and the right lung in 13 cases. The most common operative procedure was the left lower lobectomy and lingular segmentectomy, which showed 34%. The second most frequent procedure was the simple left lower lobectomy which was 22%. Incomplete resections of the multisegmental bronchiectasis were carried out in 12 cases, of which 7 cases were satisfactory Four patients underwent bilateral pulmonary resections for the severe multisegmental bilateral bronchiectases, during the first and second operations. Improvement in pulmonary symptoms was generally obtained in all four cases. The follow-up ranged from 1 week to 7 tears, with an average of 18.8 months. The overall results revealed that 87% of these and excellent or good conditions, but 13% had persistent symptoms. There was one operative death, which is a 1.5% mortality.

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Comparison of Sleep Parameters and Body Indices in Adults Obstructive Sleep Apnea and Control

  • Jin, Bok-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.4
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    • pp.188-193
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    • 2011
  • Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. Since it is closely related to sleep parameter and body indices, the study was focused on the relationship with them. The results of polysomnography (PSG) in obstructive sleep apnea was done at ENT department of Ewha women university Mokdong hospital from March to September 2010 with 52 subjects (male 35, female 17). The leads were placed to measure electroencephalogram (EEG), electrooculogram (EOG), mandibular and anterior tibialis electromyogram (EMG), airflow in nasal and oral cavity, chest and abdominal breathing pattern, snoring sound and arterial oxygen saturation ($SpO_2$) level. From sleep parameter and body indices of adult obstructive sleep apnea compared to normal adult revealed that age (p<0.01) and snoring sound (p<0.05) were increased, stage 1 sleep (p<0.01) was increased, the deeper stages (3&4) of sleep (p<0.05) were reduced. Respiratory disturbance index (RDI) (p<0.01), mean $SpO_2$ (p<0.05) and lowest $SpO_2$ (p<0.01) were also decreased. The correlation analysis from sleep parameter and body indices of OSA showed the positive correlation with age (r=0.463, p<0.001), snoring sound (r=0.278, p<0.05), stage 1 sleep (r=0.391, p<0.01) and RDI (r=0.409, p<0.01), but showed the negative correlation with the deeper stages (3&4) of sleep (r=-0.307, p<0.05), mean $SpO_2$=(r=-0.274, p<0.05) and lowest $SpO_2$ (r=-0.392, p<0.01). This study proves that obstructive sleep apnea and indices have closed related.

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Is Computerized Tomography Angiographic Surveillance Valuable for Prevention of Tracheoinnominate Artery Fistula, a Life-Threatening Complication after Tracheostomy?

  • Sung, Jae-Hoon;Kim, Il-Sup;Yang, Seung-Ho;Hong, Jae-Taek;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.49 no.2
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    • pp.107-111
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    • 2011
  • Objective : The aim of this study was to evaluate the utility of volume-rendered helical computerized tomography (CT) angiography focusing tracheostomy tube and innominate artery for prevention of tracheoinnominate artery fistula. Methods : The authors retrospectively analyzed 22 patients with tracheostomy who had checked CT angiography. To evaluate the relationship between tracheostomy tube and innominate artery, we divided into three categories. First proximal tube position based on cervical vertebra, named "tracheostomy tube departure level (TTDL)". Second, distal tube position and course of innominate artery, named "tracheostomy tube-innominate artery configuration (TTIC)". Third, the gap between the tube and innominate artery, named "tracheostomy tube to innominate artery gap (TTIG)". The TTDL/TTIC and TTIG are based on 3-dimensional (3D) reconstruction around tracheostomy and enhanced axial slices of upper chest, respectively. Results : First, mean TTDL was $6.8{\pm}0.6$. Five cases (23%) were lower than C7 vertebra. Second, TTIC were remote to innominate artery (2 cases; 9.1 %), matched with it (14 cases; 63.6%) or crossed it (6 cases; 27.3%). Only 9% of cases were definitely free from innominate artery injury. Third, average TTIG was $4.3{\pm}4.6$ mm. Surprisingly, in 6 cases (27.3%), innominate artery, trachea wall and tracheostomy tube were tightly attached all together, thus have much higher probability of erosion. Conclusion : If low TTDL, match or crossing type TTIC with reverse-L shaped innominate artery, small trachea and thin TTIG are accompanied all together, we may seriously consider early plugging and tube removal.

Theoretical Bases and Technical Application of Breathing Therapy in Stress Management (스트레스 관리 시 호흡치료의 이론적 근거와 기법 적용)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1304-1313
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    • 1999
  • Breathing is essential for life and at the same time takes a role as a antidote for stress. In the Orient, it was recognized early that respiration, mind, and body have a relation that is inseparable and therefore proper breathing is so important. However, since the mechanism of therapeutic effect by breathing have not been verified, the treatment has been continued till recent years. From that which originated in the Orient, several techniques in the west have been developed to regulate breathing, and have been applying to the clinical situation and to studies, however scientific studies are still lacking. Recently, relaxed breathing has been used as an efficient strategy for breathing therapy as it has an effect on reducing physiological tension and arousal, and, therefore can be used as a basic technique to control or manage stress. In this study, in order to provide basic information and guidelines for clinical application, which will aid in the application of the theoretical basics of breathing therapy and its technique, a review of the literative was conducted. The findings are as follows: 1. Since proper breathing not only has, physically, the important function in supplying oxygen to the body but also gives a good emotional, or pleasant state of mind, it is the first step in controlling physical and mental health. 2. The basic types of breathing can be classified into two types; ‘diaphragmatic breathing(relaxed breathing)’ and ‘chest breathing(stress breathing)’. In yoga type breathing, there are four kinds of breathing, ‘upper breathing’, ‘mid breathing’, ‘down breathing’, and ‘complete breathing’. 3. The theoretical explanation of the positive thera peutic effect of breathing therapy techniques exemplifies good brain function, sufficient air flow through the nasal passages, diaphragmatic movement, light vagal stimulation, CO2 changes and cognitive diversion but in most studies, the hypothesis of CO2 is supported. 4. The technique of breathing is designated with many names according to the muscles and techniques used for breathing, and for control of stress, diaphragmatic breathing(relaxed breathing) is explained as a basic technique best used to manage of stress. 5. The relaxed-breathing includes slow diaphragmatic breathing, breath meditation, nasal breathing, yogic abdominal breathing, Benson's relaxed response, and quiet response.

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A Case of Primary Localized Tracheobronchial Amyloidosis (원발성 국한성 기관기관지형 유전분증 1예)

  • Kwak, Yee-Gyung;Kim, Hyun-Jeong;Lee, Chung-Hwon;Kim, Sung-Yeon;Cho, Jae-Hwa;Kwak, Sung-Min;Lee, Hong-Lyeol;Kim, Joon-Mee;Han, Hye-Seung;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.174-178
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    • 2002
  • Primary pulmonary amyloidosis is a rare condition that can be classified into the tracheobronchial, diffuse alveolar septal, and nodular parenchymal type. Tracheobronchial amyloidosis is characterized by deposition of fibrilar proteins in the tracheobronchial tree, and it can be subdivided into diffuse and focal varieties. In this report, a case of diffuse tracheobronchial amyloidosis confirmed by flexible fiberoptic bronchoscopic biopsy is presented. The patient was a 43-year old male with a chief complaint of cough and sputum for 20 days and dyspnea for one day. The chest CT scan showed diffusely thickened walls of both the main and lobar bronchi with calcification. The bronchoscopic findings showed nodular lesions of the trachea, a diffuse bronchial stenosis of both the main bronchi and a pinpoint narrowing of the left upper and right middle lobar bronchus. The biopsy showed submucosal deposits of homogenous eosinophilic amyloid materials and an apple-green birefringence under polarizing microscopy following the Congo-red stain.

Repair of Coarctation (including tubular hypoplasia) in Infancy and Children (영아 및 소아 연령에서의 대동맥 교약증의 교정 수술)

  • 한재진
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.474-481
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    • 1990
  • We have experienced 44 cases of coarctation of aorta in the age of infancy and children from April 1986 to September 1989 at Seoul National University Children`s hospital. Patients were thirty males and fourteen females, and their age ranged from one month to ten years[mean 23.84 $\pm$33.06 months] with thirty-two infant cases. In the infantile age, congestive heart failure was the most common chief complaint[18/32], and above that age, frequent upper respiratory infection was most common[8/12]. We experienced thirteen cases of isolated COA, twenty-two cases of COA with VSD, eight cases of COA with VSD, eight cases of COA with intracardiac complex anomalies and one case of COA with atrial septal defect. The associated intracardiac complex anomalies were three Taussig-Bing type double outlet right ventricle, one single ventricle, one transposition of great arteries, one atrioventricular septal defect, one hypoplastic aortic arch with left heart hypoplasia, and one Tetralogy of Fallot. Operative techniques of COA were twenty-three subclavian flap arterioplasty, 12 resection and end to end anastomosis, eight onlay patch angioplasty, and I direct angioplasty after resection of web. Among the cases with other cardiac anomalies, staged operation was done in twenty-nine patients, and single stage total correction was performed only in three patients. There were seven operative mortality[15.9%], all being in infantile age group, and among fourteen cases associated with large VSD[Qp/Qs>2.0, mean pulmonary arterial pressure>50mmHg], four patients were died, but there was no mortality in patients with small VSD. With above results, we are intended to discuss about the interval between staged operation, the fate of VSD after coarctoplasty in case of COA with VSD, causes of death, complications etc.

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Epidemiological Multi-center Study of Blast Injury in Military Centers (군내 폭발손상환자 현황에 대한 다기관연구)

  • Kim, Won Young;Choi, Wook Jin;Lee, Jong Ho;Park, Ha Young;Kim, Dong Ook
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.78-84
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    • 2008
  • Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.