• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.31-38
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• 2010

Background: Data comparing the clinical characteristics and outcomes in chronic obstructive pulmonary disease (COPD) patients hospitalized with community-acquired pneumonia (CAP-COPD) and acute exacerbation (AECOPD) are very limited. Methods: Eighty episodes of hospitalization in 65 CAP-COPD patients, and 111 episodes of hospitalization in 82 AE-COPD patients were included in this study. The baseline characteristics, clinical presentations, potential bacterial pathogens and clinical outcomes in these patients were retrospectively reviewed and compared. Results: No significant differences were found between the two groups in parameters related to COPD and co-morbidities, except a higher rate of male among CAP-COPD patients. Clinical presentations by symptoms and laboratory findings on admission were significantly more severe in CAP-COPD patients, who showed higher rates of fever and crepitation, but less wheezing than AE-COPD patients. S. pneumoniae and P. aeruginosae were the most common bacterial pathogens in both groups. With no difference in the overall hospital mortality between both groups, the mean length of hospital stay was significantly longer in the CAP-COPD patients than in AE-COPD patients (15.3 vs. 9.8 days, respectively, p<0.01). Additional analysis on CAP-COPD patients showed that systemic steroid use did not influence the length of hospital stay. Conclusion: Although there was no significant difference in bacterial pathogens and overall hospital mortality between the two groups, CAP-COPD patients had more severe clinical symptoms and laboratory findings at presentation, and longer hospital stay than AE-COPD patients.

• 대한한방내과학회지
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• 제21권3호
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• pp.369-376
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• 2000

Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.182-190
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• 2017

Background: Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. Methods: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. Results: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ${\geq}6$ years. In addition, asthma was predominantly caused by rhinovirus in children aged ${\geq}6$ years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p<0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. Conclusion: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

• Tuberculosis and Respiratory Diseases
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• 제43권2호
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• pp.190-200
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• 1996

연구배경 : 장기간 진행된 심한 만성 기도 폐쇄질환 환자에서 합병된 급성 호흡부전의 치료로 기관삽관과 기계호흡이 필요한 경우가 있다. 그러나 기계호흡을 거부하거나 기계호흡의 이탈이 불가능할 것으로 예측되는 환자에서 기관삽관과 기계호흡을 대신할 수 있는 환기법이 필요할 것으로 생각된다. 최근 수면 무호흡질환 환자의 치료로 개발되었던 지속적 기도 양압 치료가 급성 혹은 만성 호흡부전의 치료로 시도되고 있다. 본 연구에서는 급성 호흡부전이 합병된 만성 기도 폐쇄환자에서 비강 마스크를 통한 BiPAP 치료를 실시하여 그 효과를 평가하였다. 방법 : 영남대학교 의과대학 부속병원 내과에 내원한 만성 기도 폐쇄환자 22명을 대상으로 하여, BiPAP 치료군으로 10명의 만성 폐쇄성 폐질 환자와 1명의 기관지 천식환자에게는 대증적 치료 및 BiPAP 치료를 동시에 실시하였고, 대조군으로 11명의 만성 폐쇄성 폐질환자에게는 대증적 치료만 시행하였다. 대증적 치료는 산소 요법, 아미노필린, 부신피질 호르몬 흡입, 베타 agonist 등의 약물을 투여하였고 BiPAP 치료시 mode는 spontaneous timed, 호흡 빈도는 분당 12회에서 20회, IPAP는 $6cmH_2O$에서 $8cmH_2O$, EPAP는 $3cmH_2O$에서 $4cmH_2O$로 설정하였고 사용 기간은 3일간이었다. 치료 효과는 호흡 빈도, modified Borg scale 및 동맥혈 가스소견으로 비교하였다. 결과 : BiPAP 치료군과 대조군 사이에 나이, 치료 시작전 호흡 빈도 동맥혈 가스소견, modified Borg scale 그리고 안정 상태에서 시행한 환기 기능검사 소견은 양군 사이에 차이가 없었다. 호흡빈도와 modified Borg scale은 BiPAP 치료군과 대조군에서 시간의 경과에 따라 모두 유의하게 호전되었으나 두군간의 차이는 없었다. 동맥혈 산소 BiPAP 치료군과 대조군에서 다 같이 치료전에 비해 치료 1일 및 3일후에는 시간에 경과에 따라 호전되었으나 BiPAP 치료군에서는 치료 1일후와 치료 3일후의 소견에도 뚜렷한 호전이 있었던 반면에 대조군에서는 의미있는 차이가 없었다. BiPAP치료군에서는 동맥혈 이산화탄소분압은 치료전과 비교하여 치료 1일후 및 3일후에는 각각 유의하게 감소되었으나 대조군에서는 유의한 감소가 없었다. pH는 BiPAP 치료군에서 치료전과 비교하여 3일후에 의의있게 증가하였으나 대조군에서는 뚜렷한 차이가 없었다. 대조군과 BiPAP치료군의 치료 전후의 평균 동맥혈가스 차이로 두 군간의 비교에서도 동맥혈 산소분압은 치료 3일째, 동맥혈 이산화탄소 분압은 치료 1일째와 3일째, pH는 치료 3일째에 각각 의미있는 (p<0.05) 차이를 보였다. 결론 : 이상의 결과로 중증 만성 폐쇄성 폐질환 환자에서 급성 호흡부전이 발생시 BiPAP 치료는 호흡곤란과 동맥혈 호흡성 가스 소견을 향상시킬 수 있는 보조적인 환기법이 될 수 있겠으며 기관 삽관에 의한 인공호흡을 대신할 수도 있을 것으로 생각된다.

• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.118-122
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• 2023

In this study, we investigate the emergence of bullous pemphigoid (BP) after the administration of the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 (SARSCOVID-19) vaccine. The study presents two cases of women, aged 47 and 53, diagnosed with BP following SARS-COVID-19 vaccination. BP is a common autoimmune blistering disorder prevalent among older populations, with an incidence rate ranging from 2 to 40 cases per million individuals. This condition arises when autoantibodies target adhesive proteins in the skin, resulting in blister formation and mucosal erosion. Drug-induced bullous pemphigoid (DIBP) shares similarities with the classic form of BP but may be influenced by medication usage. Notably, DIBP exhibits distinct characteristics, such as affecting a younger demographic and involving mucosal regions more prominently than classic BP. The growing incidence of BP is linked to factors such as an aging population and the rise of drug-induced cases. This case report provides valuable insights into comprehending DIBP, elucidating post-vaccination discomforts, particularly those related to oral lesions and the exacerbation of existing lesions. By elucidating these aspects, we aim to advance the understanding of DIBP within the medical community.

• 대한치과마취과학회지
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• 제10권1호
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• pp.34-44
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• 2010

The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.

• Tuberculosis and Respiratory Diseases
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• 제86권4호
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• pp.272-283
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• 2023

Background: In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. Methods: We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. Results: Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=-0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). Conclusion: Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established.

• 한국임상약학회지
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• 제11권2호
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• pp.89-96
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• 2001

Ziprasidone is equally effective as haloperidol in treating schizophrenia with fewer side effects and drug interactions. Ziprasidone is an atypical antipsychotic agent and works by blocking serotonin and dopamine receptors in the central nervous system, specifically 5-HT2A and D2 receptors. Low anticholinergic side-effects and low EPS would recommend the drug for use in the elderly. Ziprasidone inhibits reuptake of norepinephrine and serotonin at neurojunction sites in vitro, indicating a potential efficacy for depression and negative symptoms which often follow after exacerbation of schizophrenia. Patients with recent acute myocardial infarction and uncompensated heart failure are contraindicated to the drug due to a possibility of QT prolongation. Although ziprasidone is metabolized by cytochrome P450 3A4, there is no significant drug interaction with the drugs that induce or inhibit the isoenzyme. Ziprasidone is safe with coadministration of lithium and there has been no significant drug interaction reported with oral birth control pills.

• Journal of Chest Surgery
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• 제28권9호
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• pp.857-860
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• 1995

In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

• Journal of Chest Surgery
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• 제12권3호
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• pp.170-173
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• 1979

Since John Davy reported the first well-documented case of occlusive disease involving the branches of the aortic arch in 1839, many similar cases have been reported in literature, especially from oriental countries. The prognosis and symptoms depend on the degree and extent of the occlusive lesions and also on the importance of the arteries affected. The course may progress slowly or rapidly with remissions and exacerbation, and death may result from acute CVA, cardiac failure or pulmonary edema, and renal failure. No medical therapy has been able to alter conclusively the course of the disease, so various surgical procedures have been applied to relieve the obstruction and to prolong the life. We present the case of an 18 year-old female with multiple stenosis of the aorta, and performed the long bypass graft from descending aorta to common lilac artery, and the result was excellent.