• Title/Summary/Keyword: Critical Care

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A Case of Nonspecific Interstitial Pneumonitis Improved After Cyclosporin Therapy (Cyclosporin 치료로 호전된 비특이성 간질성 폐렴 1예)

  • Ahn, Sang Mi;Jo, Suk Kyoung;Lim, Seung Kwan;Song, Young Jun;Choi, Jun Hyuk;Sheen, Seung Soo;Oh, Yun Joung;Choi, Young Hwa;Park, Kwang Ju;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.631-635
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    • 2003
  • Idiopathic interstitial pneumonia is a group of lung disease classified by clinical, radiological and pathologic findings. Steroid is described in many reports as an effective treatment for the idiopathic interstitial pneumonitis. For the treatment of steroid non-responders, immuno-suppressive or cytotoxic agents are used as second line drug of choice. We experienced a case of nonspecific interstitial pneumonitis who was treated initially with glucocorticoid and antibiotics without effects, but later did respond to cyclosporin treatment. This 63 year-old patient was admitted due to dyspnea, cough, and sputum production. He was started on glucocorticoid and antibiotics after he was diagnosed as having nonspecific interstitial pneumonitis by open lung biopsy. The initial steroid treatment was not effective, however, after cyclosprin treatment, the patient showed clinical and radiologic improvements.

A Study of the Trends in Korean Nursing Research on Critical Care in the Last 10 Years (2008-2017) Using Integrated Review and Key Word Analysis (통합적 고찰과 키워드 분석을 이용한 최근 10년(2008-2017) 동안의 국내 중환자간호 연구 동향 분석)

  • Kang, Jiyeon;Kim, Soo Gyeong;Cho, Young Shin;Ko, Hyunyoung;Back, Ji Hyun;Lee, Su Jin
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.75-85
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    • 2018
  • Purpose : The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method : Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results : The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion : Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.

Revised Korean Cough Guidelines, 2020: Recommendations and Summary Statements

  • Joo, Hyonsoo;Moon, Ji-Yong;An, Tai Joon;Choi, Hayoung;Park, So Young;Yoo, Hongseok;Kim, Chi Young;Jeong, Ina;Kim, Joo-Hee;Koo, Hyeon-Kyoung;Rhee, Chin Kook;Lee, Sei Won;Kim, Sung Kyoung;Min, Kyung Hoon;Kim, Yee Hyung;Jang, Seung Hun;Kim, Deog Kyeom;Shin, Jong Wook;Yoon, Hyoung Kyu;Kim, Dong-Gyu;Kim, Hui Jung;Kim, Jin Woo
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.263-273
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    • 2021
  • Cough is the most common respiratory symptom that can have various causes. It is a major clinical problem that can reduce a patient's quality of life. Thus, clinical guidelines for the treatment of cough were established in 2014 by the cough guideline committee under the Korean Academy of Tuberculosis and Respiratory Diseases. From October 2018 to July 2020, cough guidelines were revised by members of the committee based on the first guidelines. The purpose of these guidelines is to help clinicians efficiently diagnose and treat patients with cough. This article highlights the recommendations and summary of the revised Korean cough guidelines. It includes a revised algorithm for the evaluation of acute, subacute, and chronic cough. For a chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered in differential diagnoses. If UACS is suspected, first-generation antihistamines and nasal decongestants can be used empirically. In cases with CVA, inhaled corticosteroids are recommended to improve cough. In patients with suspected chronic cough due to symptomatic GERD, proton pump inhibitors are recommended. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, intake of angiotensin-converting enzyme inhibitor, intake of dipeptidyl peptidase-4 inhibitor, habitual cough, psychogenic cough, interstitial lung disease, environmental and occupational factors, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and unexplained cough can also be considered as causes of a chronic cough. Chronic cough due to laryngeal dysfunction syndrome has been newly added to the guidelines.

A Case of Paraneoplastic Limbic Encephalitis Associated with Small Cell Lung Cancer

  • Ryu, Ja Young;Lee, Seung Hyeun;Lee, Eun Joo;Min, Kyung Hoon;Hur, Gyu Young;Lee, Sung Yong;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.5
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    • pp.273-277
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    • 2012
  • Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.

A Case of Pleural Paragonimiasis Confused with Tuberculous Pleurisy

  • Song, Junwhi;Hong, Goohyeon;Song, Jae-Uk;Kim, Wooyoul;Han, Seo Goo;Ko, Yousang;Chang, Boksoon;Jeong, Byeong-Ho;Eom, Jung Seop;Lee, Ji Hyun;Jhun, Byung Woo;Jeon, Kyeongman;Kim, Hong Kwan;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.4
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    • pp.175-178
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    • 2014
  • Here, we report a case of pleural paragonimiasis that was confused with tuberculous pleurisy. A 38-year-old man complained of a mild febrile sensation and pleuritic chest pain. Radiologic findings showed right pleural effusion with pleural thickening and subpleural consolidation. Adenosine deaminase (ADA) activity in the pleural effusion was elevated (85.3 IU/L), whereas other examinations for tuberculosis were negative. At this time, the patient started empirical anti-tuberculous treatment. Despite 2 months of treatment, the pleural effusion persisted, and video-assisted thoracoscopic surgery was performed. Finally, the patient was diagnosed with pleural paragonimiasis based on the pathologic findings of chronic granulomatous inflammation containing Paragonimus eggs. This case suggested that pleural paragonimiasis should be considered when pleural effusion and elevated ADA levels are observed.

A Case of Atypical Bronchial Carcinoid Treated by Cryotherapy (냉동치료로 치료된 비전형적 기관지 유암종 1예)

  • Kim, Hye-Ok;Kim, Se-Joong;Lee, Seung-Hyeun;Lee, Eun-Joo;Hur, Gyu-Young;Lee, Sung-Yong;Lee, Sang-Yeub;Kim, Je-Hyeong;Shin, Chol;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.6
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    • pp.521-525
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    • 2011
  • Bronchial carcinoid tumors are relatively uncommon neoplasms that are considered to be malignant tumors of low to intermediate grade. They are classified by pathologic features as typical or atypical carcinoids and have distinctly different prognoses and therapeutic options. Surgery is the treatment of choice in typical and atypical carcinoid tumors but the approach has been changing. Recently, several studies have described experiences using other technologies as adjuncts to bronchoscopic resection, technologies such as laser and cryotherapy with curative intent in endoluminal typical carcinoids. Here we present a case of atypical bronchial carcinoid that was treated with bronchoscopic cryotherapy.

Disseminated Mycobacterium intracellulare Infection in an Immunocompetent Host

  • Kim, Won-Young;Jang, Sun-Joo;Ok, Tae-Jin;Kim, Gwang-Un;Park, Han-Seung;Leem, Jae-Chan;Kang, Bo-Hyoung;Park, Se-Jeong;Oh, Dong-Kyu;Kang, Byung-Ju;Lee, Bo-Young;Ji, Won-Jun;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.452-456
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    • 2012
  • Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.

Two Cases of Diagnosis and Removal of Endobronchial Hamartoma by Cryotherapy via Flexible Bronchoscopy

  • Sim, Jae Kyeom;Choi, Jong Hyun;Oh, Jee Youn;Cho, Jae Young;Moon, Eul Sun;Min, Hye Sook;Lee, Byung Hyun;Park, Min Seon;Hur, Gyu Young;Lee, Sung Yong;Shim, Jae Jeong;Kang, Kyung Ho;Min, Kyung Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.3
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    • pp.141-145
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    • 2014
  • Although endobronchial hamartoma is a rare benign tumor, most patients with endobronchial hamartoma have respiratory symptoms such as obstructive pneumonia, hemoptysis, cough, or dyspnea due to bronchial obstruction. It can cause irreversible post-obstructive pulmonary destruction, thus early diagnosis and treatment is very important. Recently, there have been cases of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and electrocautery procedures for bronchoscopic treatment of malignant or benign central airway obstruction with comparable therapeutic efficacy and few complications. Bronchoscopic cryotherapy is a newly developed technique for management of central airway obstruction. Moreover, it provides diagnostic methods with improving diagnostic yield and safety. We report two cases of endobronchial hamartoma, each diagnosed and definitively treated with bronchoscopic techniques. Endobronchial biopsy and removal was successfully performed by cryotherapy via flexible bronchoscopy without notable complications. Follow-up bronchoscopic examinations excluded residual or recurrent disease.

Mycobacterium abscessus Lung Disease in a Patient with Kartagener Syndrome

  • Kim, Jung Hoon;Song, Won Jun;Jun, Ji Eun;Ryu, Duck Hyun;Lee, Ji Eun;Jeong, Ho Jung;Jeong, Suk Hyeon;Kang, Hyung Koo;Kim, Jung Soo;Lee, Hyun;Chon, Hae Ri;Jeon, Kyeongman;Kim, Dohun;Kim, Jhingook;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.136-140
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    • 2014
  • Primary ciliary dyskinesia (PCD) is characterized by the congenital impairment of mucociliary clearance. When accompanied by situs inversus, chronic sinusitis and bronchiectasis, PCD is known as Kartagener syndrome. The main consequence of impaired ciliary function is a reduced mucus clearance from the lungs, and susceptibility to chronic respiratory infections due to opportunistic pathogens, including nontuberculous mycobacteria (NTM). There has been no report of NTM lung disease combined with Kartagener syndrome in Korea. Here, we report an adult patient with Kartagener syndrome complicated with Mycobacterium abscessus lung disease. A 37-year-old female presented to our hospital with chronic cough and sputum. She was ultimately diagnosed with M. abscessus lung disease and Kartagener syndrome. M. abscessus was repeatedly isolated from sputum specimens collected from the patient, despite prolonged antibiotic treatment. The patient's condition improved and negative sputum culture conversion was achieved after sequential bilateral pulmonary resection.

A Survey on Nurses' and Physicians' Knowledge and Educational Needs on Home Ventilator (의료진의 가정용 인공호흡기 관련 지식 정도와 교육요구도 조사)

  • Cho, Soo-Hyun;Go, Myeong-Gyun;Jung, Jin-Hee;Won, Sun-Young;Lee, Hee-Og;Nam, Ji-Myoung;Oui, Mi-Sook;Yi, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.5 no.1
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    • pp.56-66
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    • 2012
  • Purpose: The purpose of this study was to investigate the knowledge and educational needs of nurses and physicians on home ventilator. Methods: The participants were 140 nurses and 47 physicians working at departments using home ventilators. The data were collected from January 30 to February 12, 2012 through a self-administered questionnaire with 32 items of the knowledge and educational needs on home ventilator. Results: The mean scores of nurses' and physicians' knowledge were 2.52 and 2.56 respectively. The mean scores of nurses' and physicians' educational needs were 3.16 and 3.06 respectively. Nurses' knowledge was associated with their experience using and receiving education about home ventilator and willingness to receive education about home ventilator education. Nurses' educational needs were associated with their present working department and experience using home ventilator. Nurses with high knowledge were more likely to have high educational needs. Physicians' knowledge and educational needs were not associated with any their general characteristics. Conclusion: Nurses' and physicians' knowledge of home ventilator were low and their educational needs on home ventilator were high. To provide high quality of care for home ventilators, it is necessary to provide nurses and physicians with education and to develop a more specific educational program for them.

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