• Perinatology
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• 제29권4호
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• pp.153-158
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• 2018

Objective: To evaluate the relationship between serum neutrophil-to-lymphocyte ratio (NLR) and severity of meconium aspiration syndrome (MAS). Methods: We retrospectively analyzed 197 neonates who admitted for MAS between 2008 and 2016 at the neonatal intensive care unit of Dong-A University Hospital. The serial changes of NLR were analyzed from 1st to 3rd day of life. The NLR was compared by disease severities (non-invasive respiratory care group vs. invasive respiratory care group and MAS with or without persistent pulmonary hypertension of the newborn [PPHN]). Results: The NLR values from 1st to 3rd day of life significantly increased and then decreased (P=0.031). The NLR of invasive respiratory care group was significantly higher than non-invasive respiratory care group at 2nd, 3rd, and average of 1 to 3 days of life. The NLR of PPHN group was significantly higher than without PPHN group at 3rd, and average of 1 to 3 days of life. Conclusion: The NLR was significantly increased and then decreased in early stage of MAS and associated with the severity of MAS.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.161-174
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• 2022

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

• Korean Journal of Radiology
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• 제21권5호
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• pp.526-536
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• 2020

Objective: This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. Materials and Methods: This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. Results: CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). Conclusion: In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

• 핵의학기술
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• 제17권1호
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• pp.48-52
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• 2013

뇌졸중, 외상성 뇌손상 및 파킨슨병 등과 같은 성인 뇌병변 환자 중 오랜 시간 침상 생활이 요구되는 경우 음식물이 나 타액의 흡인으로 인해 폐렴 및 호흡기계 질병을 일으키는 원인이 될 수 있다. 반복되는 폐렴이나 폐 증상이 있는 환자의 경우 구강을 통한 식이의 중지와 위 식도 역류를 배제한 후에도 증상이 지속된다면 타액의 흡인으로 인한 폐흡인의 가능성을 확인할 필요가 있다. 본 연구에서는 뇌병변 환자에서 흡인성 폐렴 진단을 위한 방사핵종 타액 신티그래피의 유용성을 알아보고자 한다. 2011년 12월부터 2012년 8월까지 본원 재활의학과에 입원한 뇌병변 환자 중 타액으로 인한 흡인성 폐렴 진단을 위해 핵의학과에 검사의뢰한 성인 10명(남 6명, 여 4명)을 대상으로 하였다. 검사전 금식을 하였고, $^{99m}Tc_{O4}$ 185 MBq (5 mCi)를 1 mL 미만의 용액으로 만들어 구강내에 주입하였다. 주입 즉시 20분간 동적 영상 후 정적 영상을 획득하였고, 필요시 2~4시간의 지연 검사를 하였다. 전체 10명의 환자 중 방사핵종 타액 신티그램에 양성 반응을 보인 환자는 6명으로 양성 반응율이 60%였다. 양성 반응을 보인 4명의 환자에서는 구강내 주입 후 20분간의 동적 영상에서 흡인 여부를 확인할 수 있었고, 나머지 2명의 환자에서는 4시간의 추가 지연 검사에서 흡인 여부를 확인 할 수 있었다. 타액의 흡인을 확인한 1명의 환자는 치료 후 재 시행한 추적검사에서 음성 반응을 보였다. 거동이 불가능한 뇌병변 환자에서 방사핵종 타액 신티그래피를 통해 대상자의 60%에서 타액에 의한 폐 흡인을 확인하였다. 본 연구는 흡인성 폐렴을 진단할 수 있는 타 검사에 비해 환자 자세의 변동이 불필요하고, 비교적 적은 시간과 간단한 검사 방법을 통해 진단과 치료를 위한 영상적 정보를 제공하는데 유용하리라 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제40권3호
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• pp.259-266
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• 1993

연구배경 : 전산화 단층촬영 유도하 경피적 폐침생검시 가장 많은 합병증인 기흉의 위험인자를 조사하기 위하여 폐기능 검사상 폐쇄성 환기장애 유무에 따른 기흉 발생의 정도를 조사하였다. 방법 : 흉부 X-선 사진상 종괴양음영으로 CT 유도하 경피적 폐침생검을 시행한 예들 중 시술후 기흉이 발생한 16예와 대조군으로 이들과 연령, 신장 및 체중, 흡연력, 종괴의 크기 및 깊이가 비등한 기흉이 발생하지 않은 16예를 대상으로 시술전 측정한 폐활량과 노력성 호기곡선 및 기류-용량곡선에서 계측한 여러 지표들과 폐확산능 성적을 비교 검토하였다. 결과 : 1) 폐활량 및 노력성호기곡선에서 계측한 지표들 가운데 VC와 FVC는 두군사이에 유의한 차이가 없었으나 $FEV_1$, $FEV_1$/FVC% 및 FEF25-75%은 기흉이 발생한 군에서 유의하게 감소하였으며 기류-용량곡선의 모든 계측치도 기흉이 생긴 군에서 저명하게 감소하였다. 2) $D_{LCO}$ 및 $D_{LCO}/V_A$는 개인차는 심하였으나 기흉이 생긴군에서 감소하는 경향이 있었다. 3) 폐쇄성 환기장애가 있는 경우 폐기능 검사상 정상인 군에 비해 기흉의 발생빈도가 2배 이상이었으며 기흉의 치료로써 흉관삽입술이 필요한 빈도도 6배 이상이었다. 결론 : 이상의 결과에서 경피적 폐침생검시 시술전 폐기능 검사를 통한 폐쇄성 폐질환 유무에 대한 정확한 조사는 기흉의 발생을 예측할 수 있는 하나의 인자로 고려될 수 있음을 알 수 있었다.

• Journal of Chest Surgery
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• 제41권2호
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• pp.177-188
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• 2008

배경: 이 연구에서는 급성 폐 손상 백서 모델에 nitric oxide (NO)와 sphingosine 1-phosphate (S1P)를 투여한 후, 폐 미세구조의 변화를 생체 접촉 현미경 (intravital videomicroscopy) 으로 생체 내에서 직접 관찰하고 형태학적으로 분석하여, 급성 폐 손상 치료법으로서 이들의 효과를 평가하고자 하였다. 대상 및 방법: 백서 (Sprague Dawley rat) 35마리를 5군으로 나누었다: 생리 식염수를 흡입시킨 대조군 (n=7), 0.1 N HCl을 흡입시켜 폐 손상을 유도한 폐 손상 대조군 (ALI 군, n=7), 폐 손상을 유도하고 치료제를 투여한 치료군 (S1P군, n=7; NO 군, n=7; S1P+NO군, n=7). 폐포 유순도와 간질성 부종의 정도를 평가하기 위해, 폐 손상 유도 후 60 분과 120분에 측정 가능한 모든 폐포와 폐포간 벽의 두께를 생체 접촉 현미경으로 측정하였다. 폐포 유순도는 호흡 주기에 따른 폐포 직경 변화와 일회 호흡량의 변화에 따른 직경 변화로 평가하였다. 결과: 폐 손상 유도 120분 후에, ALI 군의 폐포 유순도가 대조 군 (호흡 주기에 따른 변화 : ALI군 1.9% vs 대조군 6.5%, p=0.03; 일회 호홉량에 따른 변화: ALI군 3.2% vs 대조군 9.1%, p=0.003)과 NO군(일회 호흡량에 따른 변화: ALI군 3.2% vs NO군 16.9%, p=0.001)에 비해 의미 있게 감소하였다. 폐 손상 유도 120 분 후에, NO군의 폐포간 벽의 두께가 ALI군에 비해 작은 경향을 보였다 (ALI 군 $15.2{\mu}m$ vs NO군 $12.3{\mu}m$, p=0.06). S1P 단독으로는 폐포 유순도와 간질성 부종에 유의한 영향을 미치지 않았다. 결론: 백서 폐 손상 모델을 생체 접촉 현미경으로 관찰한 결과, NO는 폐포 유순도를 개선하고 간질성 부종을 감소시켜 폐 손상 정도를 완화시키는 것으로 사료된다.

• Journal of Chest Surgery
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• 제27권10호
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• pp.878-881
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• 1994

Primary malignant lymphomas of the lung are rare and known often to be localized, solitary pulmonary lesions, in chest radiograph. Because they are highly treatable contrast to the other primary lung cancer, the distinction is important. A 35-year old man who was admitted for a solitary pulmonary nodule in the right middle lobe. Percutaneous needle aspiration disclosed diffuse, small cell lymphoma. Bone marrow biopsy showed no evidence of neoplastic lymphoid cell infiltration. There were a walnut sized mass involving right middle lobe with a small satellite nodule at 2cm distal to the right upper lobe bronchial orifice. The histopathology of the bilobectomized specimen showed diffuse, small cell, malignant, non-Hodgkin`s lymphoma. Immunologic subtype was defined as B-cell type.

• Journal of Chest Surgery
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• 제22권2호
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• pp.315-320
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• 1989

Dysphagia is common symptom in patients with advanced esophageal cancer, which is not to be resected surgically. Especially when esophagorespiratory fistula is complicated, it leads to rapid deterioration and death due to pulmonary infection. Esophageal intubation relieves dysphagia as simple surgical execution and offers rapid effectiveness. For six patients with inoperable esophageal cancer including three esophago-respiratory fistulas, the palliative esophageal intubation was performed in Korea Cancer Center Hospital, in 1988. Traction technique via high gastrotomy with Celestin tube was used. Adequate palliation of dysphagia was achieved in 5 patients, but wound infection was developed in 2 patients, tube migration in 2 patients, and 2 died in hospital due to sepsis on the 16th and 42nd postoperative day, respectively. In 3 patients with esophagorespiratory fistula complicated after radiation therapy, the intubation was performed urgently and the result was satisfactory in 2 of them that the fistula was occluded successfully and aspiration or pulmonary infection was prevented.

• Journal of Chest Surgery
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• 제32권10호
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• pp.954-957
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• 1999

Primary malignant lymphomas of the lung are rare neoplasms representing 3.6% of all extranodal lymphomas and less than 1% of pulmonary malignancies, with its distinct clinicopathological features. A 60-year-old symptomatic man, who was a former non-smoker, had a cough and sputum. Chest roentgenogram and computed tomographic scan showed the presence of a posterior mass in the basal segment of the right lung. Transthoracic needle aspiration cytology was inadequate for the diagnosis of cancer. A subsequent right thoracotomy was carried out, which showed a primary pulmonary lymphoma of the bronchus-associated lymphoid tissue.

• 대한세포병리학회지
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• 제19권1호
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• pp.9-15
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• 2008

The major categories of neuroendocrine tumors of lung are typical carcinoid, atypical carcinoid, large cell neuroendocrine carcinoma, and small cell carcinoma. The histologic classification criteria of neuroendocrine tumors are well documented in the "WHO Classification of Tumors" based on mitotic figures and necrosis. Cytologic characteristics of neuroendocrine tumors are trabecular, acinar, and solid arrangement of tumor cells and occasional rosette formation. Nuclear chromatin patterns are characteristically described as "salt and pepper chromatin pattern". Many of cytologic classifications documented in the literature are before the "WHO Classification". In this review, the cytologic features of pulmonary neuroendocrine tumors are documented according to the WHO classification, and recent concepts of neuroendocrine tumors of lung are discussed.