• Title/Summary/Keyword: Pulmonary aspiration

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Clinical Study on Thoracic Actinomycosis (흉부 방선균종의 임상적 고찰)

  • Hong, Sang-Bum;Kim, Woo-Sung;Lee, Jae-Hwan;Bang, Sung-Jo;Shim, Tae-Son;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Lee, In-Chul;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1058-1066
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    • 1998
  • Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

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Metastatic Malignant Fibrous Histiocytoma in Lung -One Case Report- (폐로의 전이성 악성 섬유성 조직구종 -1예 보고-)

  • 이석열;이만복;이길노;고은석
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.671-674
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    • 1999
  • At OPD follow-up in December 1998, chest x-ray of a 42-year-old female showed a solit ary pulmonary nodule at a superior basal segment in the right lower lobe. After percut aneous transthoracic needle aspiration failure, wedge resection of the superior basal segment of lower lobe in right lung was performed for diagnosis and therapy. Three years ago, she had received surgery to remove a mass in the left buttock. The mass was pathologically diagnosed as malignant fibrous histiocytoma. She subsequently received 4500 rad radiotherapy for 35 days. Pathology confirmed metastatic malignant fibrous histiocytoma of the lung.

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Postoperative Systemic Dissemination of Injected Elemental Mercury

  • Kang, Suk-Hyung;Park, Seung-Won;Moon, Kyung-Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.245-247
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    • 2011
  • There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

Clinical experience of open heart surgery: 211 cases (개심술 211례에 대한 임상적 고찰)

  • 강인득
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.804-810
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    • 1984
  • Two hundred twenty one cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1984. 1.There were 154 cases [73%] of congenital anomalies and 57 cases [27%] of acquired valvular heart diseases. Among the congenital cases, 128 cases were acyanotic and 26 cases were cyanotic. Among the 57 cases of acquired valvular replacement surgery, 3 cases had open heart commissurotomy, one had Kay annuloplasty. 2.The age distribution of the congenital acyanotic anomalies ranged from 5 to 32 years with mean age of 12.8 years, the congenital cyanotic anomalies from 3 to 29 years with mean age of 14.2 years and the acquired valvular diseases from 9 to 51 years with mean age of 30 years. The difference of sex distribution was no significance. 3.Three methods for debubbling process were used in our institute, in 133 cases, the vent was inserted into the left ventricular apex, in 61 cases inserted into the left atrium through right superior pulmonary vein and in 17 cases used needle aspiration only. 4.For cardioplegia, the GIK solution was infused repeatedly from 30 to 40 minutes interval and brought excellent results for myocardial protection during open heart surgery. 5.Overall mortality was 7.6%. The mortality along with each disease is 1.56% in congenital acyanotic cases, 26.9% in congenital cyanotic cases and 12.3% in acquired valvular disease.

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Lesion Mimicking Lung Tumor (폐종양으로 오인된 병소)

  • Ko, Hoon;Cho, Yongseon;Lee, Yang Deok;Han, Min Soo;Kang, Dong Wook
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.197-200
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    • 2004
  • A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{\times}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.

EFFECT OF DRAINAGE VIA DENTAL ROOT CANAL & EXTRACTION WOUND IN THE UNCONSCIOUS PATIENT WITH CONTINUOUNS SELF-BITE WOUNDS (지속적인 교상을 가진 무의식 환자에서 치근관 및 발치창 통한 배농술의 효과 : 증례 보고)

  • Kim, Jong-Bae;Yoo, Jae-Ha;Choi, Byung-Ho;Moon, Seon-Jae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.457-463
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    • 2001
  • In the unconscious patient with general muscle rigidity, the natural teeth can be luxated and then bite wounds may be occurred around lip, owing to the pathologic involuntary self-biting habit. If the forceful biting is generated continuously, the teeth may be avulsed and aspirated into the aerodigestive tract with the infection of biting wound. For the prevention of pulmonary aspiration of the teeth and wound infection, the biting teeth should be cared before the fact. The authors treated the teeth as endodontic drainage with removal of the crown or iodoform gauze drainage into the socket with extraction of the teeth. The prognosis was more favorable without biting wounds.

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Clinical Study of Tracheocutaneous Fistula (기관피부누공에 대한 임상적 고찰)

  • Lee, Hyung-Seok;Kim, Hyun-Soo;Shim, Bong-Taek;Tae, Kyung;Park, Chul-Won
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.142-145
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    • 1995
  • The tracheocutaneous fistula(TCF) may develop infrequently as a complication after tracheostomy. Prolonged tracheostomy tube dependence increases the risk of TCF developing, and in growth of stratified squamous epithelium lines the furrow connecting the tracheal mucosa and the skin, accounting for persistence of the fistulous tract. Such fistulas are a nuisance and create nursing and social problems including poor hygiene, aspiration, difficulty with speech, and depletion of pulmonary reserve. Surgical closure has generally been successful by primary closure, fistulectomy with primary closure, and closure by secondary intention following excision of the tracheocutaneous fistula. No large series compares the efficacy of these techniques and each has its own merits. Recent literature has purposed to minimizing complications. For ten years, from January 1985 to December 1994, the authors experienced 25 cases of TCF which were analyzed in respect to incidence and interval of cannulation, duration between decanulation and fistular closure, precedent disease, closure methods, and complications of TCF repair.

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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.

Implementation of Multi-frame Medical Image Labeling Web Application for Swallowing Disorder Analysis (삼킴장애 분석을 위한 멀티프레임 의료영상 라벨링 웹 애플리케이션 구현)

  • Dong-Wook Lim;Chung-sub Lee;Si-Hyeong Noh;Chul Park;Min Su Kim;Hee-Kyung Moon;Chang-Won Jeong
    • Proceedings of the Korea Information Processing Society Conference
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    • 2023.05a
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    • pp.8-10
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    • 2023
  • 삼킴장애는 음식물이 입에서 식도로 가지않고 걸리거나 기도(Trachea)로 흡입되는 문제를 갖는 상태이다. 특히 노인이나 신경계 질환을 앓는 환자의 경우 기도로 흡입된 음식덩이가 폐렴을 일으키고 결국에는 사망으로 이어지기에 적절한 치료와 관리가 요구된다. 보통 영상으로 판단할 수 있는 삼킴단계는 구강준비단계(Oral Preparatory Phase), 구강단계(Oral Phase), 인두단계(Pharyngeal Phase), 식도단계(Esophageal Phase) 4가지로 분류하고 삼킴장애는 침습(Penetration)과 흡인(Aspiration)으로 크게 2가지로 분류한다. 본 논문에서는 이러한 6가지 클래스를 가지는 삼킴장애 환자 비디오 파일을 라벨링하기 위한 웹 애플리케이션을 제안한다. 이를 구현하기 위해서 대용량 멀티프레임 이미지를 수신해서 분리하여 저장하도록 개발하였다. 또한 음식덩이를 정교하게 분할할 수 있도록 GrabCut 알고리즘을 적용하여 라벨링할 수 있도록 하였다. 차후 라벨러와 전문의 간의 협업이 가능하도록 라벨링 데이터의 상태를 관리할 수 있도록 개발하고자 한다.

Incidence and Risk Factor of Pneumothorax After Percutaneous Fine Needle Aspiration Biopsy of the Lung (경피폐세침흡인생검시 기흉의 발생빈도와 위험인자)

  • Choi, Cheon Woong;Yoo, Jee Hong;Chin, Hyoun Jung;Park, Myoung Jae;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.628-637
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    • 2004
  • Background : Percutaneous needle aspiration biopsy(PNAB) of the lung is a safe procedure for diagnosis of various pulmonary diseases but complications such as pneumothorax can occasionally develop. We reviewed the complications arising after PNAB and analysed the risk factors of pneumothorax. Method : We collected data by reviewing medical records and radiographic studies of 403 patients who underwent PNAB of the lung between 1988 and 2002 and analyzed the risk factors of pneumothorax. Result : The incidence of complication was 12.9%, 48 patients with pneumothorax and 4 patients with mild hemoptysis. Among the 48 pneumothorax patients, 35 patients showed mild(<20%) and was treated by only oxygen supply, 11 patients had severe pneumothorax(>50%) and chest tube insertion was done and 2 patients were treated by needle aspiration. As the results of multivariate analysis, size and location of lesion, location of approach, diagnosis of lesion showed no significant relationship, while age and gender of patients(p<0.05) and the depth of approach(p<0.001) were significantly related to pneumothorax. Smoking amount(p<0.001) as well as the smoking history(p<0.005) were also significantly related and the examiner displaying various incidence of pneumothorax from 4.0% to 23.1% among individuals also was a significant independent risk factor(p<0.05). While the average depth of approach for 13 patients treated by chest tube insertion or needle aspiration was $8.2{\pm}1.2cm$, 35 patiens treated only by oxygen supply was $6.7{\pm}1.6cm$ suggesting that the depth of approach was lead to a severe pneumothorax. Conclusion : The independent risk factors of pneumothorax, the most common complication after PNAB, are age and gender of patients, depth of approach, examiner of procedure, smoking history and smoking amount.