• Title/Summary/Keyword: Pneumonia, Aspiration

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A Case of Chlorfluazuron Insectisides Poisoning with Mental Change (클로르플루아주론 살충제 음독 후 발생한 의식변화 1례)

  • Park, Eun Suk;Kang, Soo;Kim, Ah Jin;Baek, Jin Hue;Jung, Hyun Min
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.40-42
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    • 2015
  • Benzoylureas are chemical compounds best known for their use as insecticides. Diflubenzuron is one of the more commonly used benzoylurea pesticides. Others include chlorfluazuron, flufenoxuron, hexaflumuron, and triflumuron. They act as insect growth regulators by inhibiting synthesis of chitin in the body of the insect. They have low toxicity in mammals because mammals have no chitin. Chlorfluazuron insecticides, which are mixed with solvent naphatha, are commonly used. Thus we assume that in the presented case mental change outcome of poisoning was connected with toxic effects of solvent naphtha rather than with chlorfluazuron action. Components of solvent naphtha, particularly trimethylbenzenes, exert strong irritant action on the gastric mucosa and are very well absorbed from the gastrointestinal tract. We report on a 67-year-old man with stuporous mentality after intentional ingestion of approximately 200 ml of liquid chlorfluazuron in a suicide attempt. He was discharged after conservative treatments including gastric irrigation, charcoal, mechanical ventilation, hydration, and antibiotics for aspiration pneumonia without complications.

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Totally Laparoscopic Total Gastrectomy Using Intracorporeally Hand-Sewn Esophagojejunostomy

  • So, Kwang-Oh;Park, Jong-Min
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.206-211
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    • 2011
  • Purpose: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. Materials and Methods: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. Results: The mean age was 66.5 years and mean body mass index (kg/$m^2$) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. Conclusions: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.

A Case of Acute Intoxication with Glyphosate and Oxyfluorfen Containing Powder Herbicide ($Daejangun^{(R)}$) (Oxyfluoren이 함유된 입제 glyphosate 제초제(대장군) 급성 중독 1예)

  • Lee Seung Hee;Yi Kum Ho;Yoo Sung-Soo;Roh Heung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.110-113
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    • 2005
  • Glyphosate containing herbicides are an alternative to paraquat and have been widely used with increasing frequency in suicide attempts throughout Asia. It is an organophosphorus compound that is not a cholinesterase inhibitor. Daejangun powder consists of glyphosate ammonium, surfactant and another herbicide, oxyfluorfen. A 60-year-old man ingested about 300 g of Daejangun powder with 500 ml of water in a suicide attempt. He was brought to emergency room 6 hours after the ingestion and showed severe metabolic acidosis (pH 6.75), marked leukocytosis (WBC 35,800/$mm^3$), hypoglycemia (glucose 13 mg/dL) and increased liver enzymes (AST/ALT 1,683/418 IU/L). Later he developed aspiration pneumonia, acute renal failure and hyperchloremic acidosis. Upper gastrointestinal endoscopy which performed 5 days after the ingestion revealed corrosive injuries (grade 1) in both esophagus and stomach. However, intensive treatment with supportive measures improved the abnormal findings almost completely 4 weeks after the ingestion.

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A Case of Tracheo-Innominate Artery Fistula after Tracheostomy (기관절개술 후 발생한 기관무명동맥루 1예)

  • Lee, Jae Hun;Hong, Seok Min;Kim, Yong Bok;Park, Il-Seok
    • Korean Journal of Bronchoesophagology
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    • v.18 no.2
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    • pp.56-59
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    • 2012
  • Tracheo-innominate artery fistula (TIF) is a rare but catastrophic and almost always fatal complication of tracheostomy. TIF can occur anytime but is commonly present 3 to 24 days after tracheostomy. It can first manifest as massive bleeding around and through the tracheostomy tube, but it can also manifest as a small amount of blood with temporary spontaneous resolution. If TIF is suspicious, airway management and prompt surgical intervention are needed. In an 83-year-old man with CVA history 20 years earlier and who had recurrent aspiration pneumonia, tracheostomy was performed for respiratory management and ventilator support. On day 7 post-tracheostomy, the patient had bleeding from the tracheostoma. Immediate surgical exploration was performed to control the bleeding. A defect was seen at the post wall of the innominate artery. The erosive portion of the artery was sutured, but the patient died three weeks after the surgery due to rebleeding and respiratory failure. We present a patient who developed TIF after tracheostomy, with literature review.

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Congenital Esophageal Atresia with Tracheoesophageal Fistula -A Case Report- (선천성 식도폐쇄 및 기관식도루 -1례 보고-)

  • Lee, Mun-Geum;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.489-493
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    • 1994
  • Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

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Positional relationship between the posterior belly of digastric and the stylohyoid variant (붓목뿔근 닿는곳 변이와 두힘살근 사이의 위치관계)

  • Han, Ji Yong;Yoon, Sang-Pil;Chang, In-Youb
    • Journal of Medicine and Life Science
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    • v.15 no.1
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    • pp.12-15
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    • 2018
  • Digastric and stylohyoid muscles are located in the suprahyoid region. There have been few studies about the general morphology of stylohyoid muscle and its relationship with digastric muscle. During routine educational dissection, unusual insertion of bilateral stylohyoid muscle was found in the cadaver of a 92-year-old Korean male, whose cause of death was 'aspiration pneumonia'. Stylohyoid muscle arose from the styloid process, and inserted onto the intermediate tendon of digastric muscle and the hyoid bone on both sides. Each digastric muscle normally consists of an anterior belly, intermediate tendon and a posterior belly. In this cadaver, there were two anterior bellies on right side while one anterior belly was found on left side. Stylohyoid muscle ran medial to the intermediate tendon of digastric muscle on both sides. The anatomical relationship between stylohyoid and digastric muscles was reviewed based on morphological and embryological point of view.

An Experience of Judicial Autopsy for a Death by Muscular Dystrophy: An Autopsy Case (근이영양증으로 인한 사망의 사법부검 사례 경험: 증례 보고)

  • Kim, Youn Shin;Park, Ji Hye
    • The Korean Journal of Legal Medicine
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    • v.42 no.4
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    • pp.159-163
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    • 2018
  • Progressive muscular dystrophy (PMD) is a primary muscle disease characterized by progressive muscle weakness and wasting, which is inherited by an X-linked recessive pattern and occurs mainly in males. There are several types of muscular dystrophies classified according to the distribution of predominant muscle weakness including Duchenne and Becker, Emery-Dreifuss, facioscapulohumeral, oculopharyngeal, and limb-girdle type. Clinical manifestations of PMD are clumsy, unsteady gait, pneumonia, heart failure, pulmonary edema, hydropericardium, hydrothorax, aspiration, syncopal attacks, and sudden cardiac death. The deceased was a 34-year-old man, and the onset of the first clinical symptom, gait disturbance, was in his late teens. His elder brother had the same disease and experienced brain death after a head trauma and died after mechanical ventilation was discontinued. After an autopsy, we found contracture of the joints, pseudohypertrophy of the calf, wasting and fat replacement of the thigh muscle, pericardial effusion (80 mL), fibrosis and fat replacement of the cardiac ventricular wall, pulmonary edema, and froth in the bronchus. The cause of death was heart failure and dyspnea due to muscular dystrophy. There was no sign or suspicion of foul play in his death.

Acute Respiratory Distress Syndrome after Rotavirus Infection in a C1q Nephropathy Patient: A Case Report

  • Kim, Hye Jin;Min, Jeesu;Kim, Ji Hyun;Choi, Yu Hyeon;Han, Mi Seon;Ha, Il-Soo;Kang, Hee Gyung
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.122-127
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    • 2021
  • C1q nephropathy is a rare glomerulopathy that typically presents with nephrotic syndrome in children. Treatment with immunosuppressive agents renders patients vulnerable to infection and its complications. Gastroenteritis is common in children, and rotavirus is a leading cause. Extraintestinal manifestations of rotavirus have recently been reported; however, there is a paucity of cases exploring the involvement of a rotavirus on the respiratory system. Acute respiratory distress syndrome (ARDS) is a rapid onset respiratory failure characterized by noncardiogenic pulmonary edema and hypoxemia. Causes of ARDS include sepsis, pneumonia, pancreatitis, aspiration, and trauma. In this paper, we report a case of ARDS after rotavirus infection in a child with C1q nephropathy who had been treated with immunosuppressive agents.

A Case of Bilateral Tension Pneumothorax after the Successful CO2 Laser-assisted Removal of a Bronchial Foreign Body in a Child

  • Mun, In Kwon;Ju, Yeo Rim;Lee, Sang Joon;Woo, Seung Hoon
    • Medical Lasers
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    • v.9 no.1
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    • pp.65-70
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    • 2020
  • Bronchial foreign body aspiration (BFA) is a common but emergent condition in infants and children. Furthermore, it can result in various complications such as atelectasis, pneumonia, bronchiectasis, and pneumothorax. Among these, pneumothorax is a very rare complication. However, it can be fatal without the swift implementation of appropriate treatment. We experienced a case of 16-month-old girl with an aspirated peanut. The foreign body was fixed in her left main bronchus. A CO2 laser was used to safely cut and break the foreign body. Removal was successful after breaking it. But after the process, inflammatory tissue of the tracheal mucosa was ruptured. Bilateral tension pneumothorax followed after the rupture. The patient was treated with bilateral chest tube insertion. Here we present this BFA case with a rare and unexpected complication. We also review the appropriate literature.

Delayed Clinical Signs Associated with Cerebellar Lesion in Holstein Calf Infected with Bovine Viral Diarrhea Virus

  • Choi, Woojae;Ro, Younghye;Hong, Leegon;Kim, Eunkyung;Choe, Eunhui;Kim, Danil
    • Journal of Veterinary Clinics
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    • v.39 no.1
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    • pp.38-43
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    • 2022
  • A 5-month-old Holstein downer calf was presented, and bovine viral diarrhea virus was detected in the feces and the cerebrospinal fluid. Combined treatment of recombinant bovine somatotropin (rBST) administration and standing rehabilitation had been performed for two months, and the calf could maintain the standing position for a while. However, the symptoms were not improved, and the calf died due to ruminal tympany and aspiration pneumonia. Megaesophagus, abomasal ulcer, and a normal-sized but softened cerebellum were observed in clinical necropsy. Improvement of symptoms was confirmed by rBST, but was not reached the complete recovery of gait and standing position.