• 제목/요약/키워드: Critical Care

검색결과 1,875건 처리시간 0.031초

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver;Raman, Sainath;Suen, Jacky Y.;Cho, Hwa Jin;Fraser, John F.
    • Clinical and Experimental Pediatrics
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    • 제64권5호
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    • pp.188-195
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    • 2021
  • Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.

Clinical Characteristics of Chronic Cough in Korea

  • An, Tai Joon;Kim, Jin Woo;Choi, Eun Young;Jang, Seung Hun;Lee, Hwa Young;Kang, Hye Seon;Koo, Hyeon-Kyoung;Lee, Jong Min;Kim, Sung-Kyung;Shin, Jong-Wook;Park, So Young;Rhee, Chin Kook;Moon, Ji-Yong;Kim, Yee Hyung;Lee, Hyun;Kim, Yong Hyun;Kim, Je Hyeong;Lee, Sang Haak;Kim, Deog Kyeom;Yoo, Kwang Ha;Kim, Dong-Gyu;Jung, Ki-Suck;Kim, Hui Jung;Yoon, Hyoung Kyu;Cough Study Group of the Korean Academy of Tuberculosis and Respiratory Diseases
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.31-41
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    • 2020
  • Background: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines. Methods: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, exsmokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines. Results: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response. Conclusion: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.

A Promising Treatment for Broncholith Removal Using Cryotherapy during Flexible Bronchosopy: Two Case Reports

  • Lee, Jong Hwan;Ahn, Joong Hyun;Shin, Ah Young;Kim, Sung Jin;Kim, Sung Jun;Cho, Gu-Min;Oh, Hyun Jin;Kim, In Ho;Kim, Ju Sang
    • Tuberculosis and Respiratory Diseases
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    • 제73권5호
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    • pp.282-287
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    • 2012
  • Broncholiths are defined as calcified materials that occur in a tracheobronchial tree or in a cavity communicating with that. Broncholith has variable clinical features. The therapeutic options to remove broncholiths are so variable that clinicians need to select the most safe and effective methods by mass size, mobility, and location. As yet, there is no consistent guideline removing a broncholith. We report 2 successful cases of removing a fixed broncholith by flexible bronchoscopy guided cryoadhesion. With repeated technique of thawing and freezing with cryoprobe, we could extract the fixed broncholith safely. This method is promising as a way to remove broncholith in the future.

원인 미상으로 Chylothorax와 Chyluria가 병발한 1예 (A Case of Idiopathic Chylothorax and Chyluria)

  • 최정민;오형철;이명준;윤재필;김재일;김우성;김동순;김원동;심태선
    • Tuberculosis and Respiratory Diseases
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    • 제57권4호
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    • pp.377-380
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    • 2004
  • 유미흉은 주로 악성종양에 의한 흉관의 폐쇄, 유미뇨는 림프관과 요관과의 누공형성이 주된 원인이다. 저자들은 유미흉의 원인으로 섬유육종에 의한 흉관폐쇄, 유미뇨의 원인으로 요로계와 림프관의 누공형성을 의심하였으나 검사상 증거를 찾을 수 없어 특발성 유미흉 및 특발성 유미뇨로 진단한 1예를 문헌고찰과 함께 보고하는 바이다.

H1N1 Influenza 폐렴 환자에서 발생한 Mycobacterium abscessus 감염 1예 (A Case of Mycobacterium abscessus Lung Disease in a Patient with H1N1 Influenza Pneumonia)

  • 정경원;유훈;이태훈;권오성;최석원;강세훈;심태선;김동순;송진우
    • Tuberculosis and Respiratory Diseases
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    • 제69권3호
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    • pp.207-211
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    • 2010
  • Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days' ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.

폐림프관종증 1예 (A Case of Pulmonary Lymphangiomatosis)

  • 장은경;김창래;최창민;오연목;심태선;이상도;김우성;김동순;송진우
    • Tuberculosis and Respiratory Diseases
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    • 제70권5호
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    • pp.428-432
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    • 2011
  • Pulmonary lymphangiomatosis is a rare disorder involving the entire intrathoracic lymphatic system from the mediastinum to the pleura. Pulmonary lymphangiomatosis mostly occurs in children and young adults without gender predilection. Although it is pathologically benign, it shows a progressive and fatal course with variable initial presentation. We now report a case of pulmonary lymphangiomatosis in a 35-year-old man. He presented with hemoptysis 6 months previously. Chest x-ray and a chest computed tomography scan showed diffuse interstitial thickening with left pleural effusion. Chylothorax was confirmed by thoracentesis. Lymphangiography showed dilated and tortuous lymphatic channels. Surgical lung biopsy revealed proliferation of complex anastomosing lymphatic channels. He was diagnosed with pulmonary lymophangiomatosis. Closed thoracostomy and chemical pleurodesis were done and the dyspnea was reduced.

Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

  • Hong, Goohyeon;Song, Junwhi;Lee, Kyung-Jong;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • 제74권4호
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    • pp.177-180
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    • 2013
  • We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.

A Case of Human Pulmonary Dirofilariasis in a 48-Year-Old Korean Man

  • Kang, Hyo Jae;Park, Young Sik;Lee, Chang-Hoon;Lee, Sang-Min;Yim, Jae-Joon;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Chai, Jong-Yil;Lee, Jinwoo
    • Parasites, Hosts and Diseases
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    • 제51권5호
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    • pp.569-572
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    • 2013
  • Dirofilariasis is a rare disease in humans. We report here a case of a 48-year-old male who was diagnosed with pulmonary dirofilariasis in Korea. On chest radiographs, a coin lesion of 1 cm in diameter was shown. Although it looked like a benign inflammatory nodule, malignancy could not be excluded. So, the nodule was resected by video-assisted thoracic surgery. Pathologically, chronic granulomatous inflammation composed of coagulation necrosis with rim of fibrous tissues and granulations was seen. In the center of the necrotic nodules, a degenerating parasitic organism was found. The parasite had prominent internal cuticular ridges and thick cuticle, a well-developed muscle layer, an intestinal tube, and uterine tubules. The parasite was diagnosed as an immature female worm of Dirofilaria immitis. This is the second reported case of human pulmonary dirofilariasis in Korea.