• Tuberculosis and Respiratory Diseases
• /
• 제72권2호
• /
• pp.177-181
• /
• 2012

Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

• Tuberculosis and Respiratory Diseases
• /
• 제79권1호
• /
• pp.37-41
• /
• 2016

Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.

• Allergy, Asthma & Respiratory Disease
• /
• 제6권6호
• /
• pp.303-309
• /
• 2018

Purpose: Foreign body aspiration in children is emergent and can cause serious complications. This study aims to show the clinical characteristics of foreign body aspiration and to analyze the clinical cases of delayed diagnosis to predict and prevent complications. Methods: We retrospectively reviewed the medical records of 63 children (48 in Inha University Hospital and 15 in Gachon University Gil Medical Center) who were diagnosed with foreign body aspiration through bronchoscopy from 1996 to 2017 in Incheon City, and analyzed clinical characteristics. Patients were divided into 3 groups: those were diagnosed within 24 hours, delayed after 24 hours, or delayed more than 7 days according to time elapse from the time of foreign body aspiration, and clinical characteristics of each group were compared. Results: Aspiration occurred in 58.7% at 1 year and 15.9% at 2 years. Cough (65.1%) and coarse breathing sound (41.3%) were most common, and radiologic findings were commonly presented as emphysema on the affected side (41.3%). Nuts were most common (42.9%), and there was no difference in the frequency between the right and left main bronchi. The documented history of foreign body aspiration was more frequently found in the early diagnosed group; however, sputum, fever, and complications were more frequent in the delayed diagnosed group. Conclusion: If a patient with respiratory disease has persistent fever or sputum, foreign body aspiration should be suspected.

• 대한수의학회지
• /
• 제29권4호
• /
• pp.577-587
• /
• 1989

소의 하부호흡기계 질병을 진단하고자 기침과 비루를 주증상으로 하는 31두의 환우와 임상증상을 나타내지 않는 9두의 소에 5 fr. urinary catheter를 이용한 transtracheal aspiration technique를 적용하고 이 방법의 유용성 및 분리된 병원성 세균과 세포상을 임상증상과 관련하여 조사하여 다음과 같은 결과를 얻었다. Transtracheal aspiration technique은 구강내 정상상재균에 오염되지 않은 가검물을 하부호흡기로부터 채취하는데 호흡장애와 합병증을 유발하지 않았다. 총 40두로부터 분리한 세균중 Pasteurella multocida가 48.7%로 가장 많이 분리되었으며 점액 화농성 염증이 40%로 가장 많이 나타났다. 심한 임상증상을 보인 소중 점액화농성 염증이 60%로 가장 많이 나타났으며 Pasteurella multocida가 63.2%로 높게 분리되었다. 경미한 임상증상을 보인 소에서는 염증세포에 따른 세포상이 고루 나타났으며 Pasteurella multocida가 40% 분리되었다. 세포학적 관찰에서는 정상인 경우는 섬모원주상피세포가 다수 관찰되었고 점액성 염증인 경우는 소수의 호중구 및 상피세포가 관찰되었으며 점액화농성 염증인 경우는 다수의 밀집된 호중구, 상피세포 및 점조한 삼출물이 동시에 관찰되었다. 복합세포성 염증에서는 대식구, 호중구, 임파구 및 상피 세포가 혼재하였다. 이상의 결과로부터 transtracheal aspiration technique은 소의 하부호흡기계 질병을 진단하는데 실제 임상에서 응용할 수 있는 쉽고 안전하며 유익한 방법으로 사료된다.

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

• Tuberculosis and Respiratory Diseases
• /
• 제75권4호
• /
• pp.135-139
• /
• 2013

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming a standard method for invasive mediastinal staging and for the diagnosis of paratracheal and peribronchial lesions. It is essential to understand the technical aspects of EBUS-TBNA to ensure safe and efficient procedures. In this review, we discuss the practical aspects to be considered during EBUS-TBNA, including anesthesia, manipulation of equipment, understanding mediastinal ultrasound images, target selection, number of aspirations needed per target, sample handling, and complications.

• The Korean Journal of Pain
• /
• 제25권2호
• /
• pp.126-129
• /
• 2012

Opioid analgesia is the primary pharmacologic intervention for managing pain. However, opioids can cause various adverse effects including pruritus, nausea, constipation, and sedation. Respiratory depression is the most fatal side effect. Therefore, cautious monitoring of respiratory status must be done after opioid administration. Here, we report a patient who suffered from respiratory depression with deep sedation and aspiration pneumonitis after intrathecal morphine administration.

• 대한의생명과학회지
• /
• 제8권2호
• /
• pp.63-69
• /
• 2002

This study was performed to investigate the effectiveness of the aspiration trap method for collection of sputum by comparing with the conventional method which was collecting specimens at canular cap swab. In this study, the author tested by two methods to collect specimens from 46 patients who were cared with tracheostomy and intubation at the intensive care unit of an university hospital in Pusan, and investigated the incidence of the lower respiratory tract infection, the consistency between the two methods, the level of specimen contamination. Major results were as follows: Among the patients, 35 were cared with tracheostomy and 11 were cared with intubation. In clinical diagnosis we were classified the subjects in to two group, 17 of pneumonia group and 29 of non-pneumonia group. A total of 247 strains were isolated. Among them, most three strains were Serratia marcescens (62 strains; 25.1%), Pseudomonas aeruginosa (52 strains; 21.1%), and Acinetobacter baumannii (19 strains; 7.8%). Out of total, 188 (76.1%) strains were Gram negative bacilli. The isolated strains by the aspiration trap method were the average 2.1 strains, but by the canular cap swab method were 1.6 strains. In spite of the high contaminated possibility from the incision site and the oral cavity swab, the low isolated rates of the canular cap may be the dried environment of the canular of cap area. But the contamination rates were 57.2% of the canular cap, 51.5% of the oral swab and 50.5% of the incision site swab, respectively. The consistency of predominant microorganisms according to collection method were 86.7% of aspiration, 78.3% of canular, 74.3% of incision, and 63.6% of oral. In conclusion, the aspiration trap method fur the sputum collection from the patients with intubation of tracheostomy showed the lower contamination rate of the specimens and it was helpful for rapid, accurated interpretation of the lower respiratory tract infection and hospital infection.

• Tuberculosis and Respiratory Diseases
• /
• 제64권5호
• /
• pp.356-361
• /
• 2008

연구배경: 국내에서 굴곡성 기관지경에 의해 기도 내 이물이 확인된 성인 환자에서 흡인의 위험도에 따른 임상적 특징 및 이물 제거 방법 및 결과에 대한 보고가 없어 본 연구를 계획하였다. 방법: 1994년 12월부터 2004년 12월까지 경희대학교 부속병원에서 굴곡성 기관지경을 시행하여 기도 내 이물이 확인되었던 29명의 성인 환자를 대상으로 면밀한 의무 기록을 바탕으로 후향적 분석을 시행하였다. 결과: 14명은 흡인의 위험인자가 없었던 반면 15명은 흡인의 위험도가 높은 중추신경계 질환을 가지고 있었다. 전체 환자 중, 7명(24.1%)은 흡인에 대한 과거력이 없었다. 22명의 환자가 호흡기 증상이 확인되었는데, 기침(62.0%), 호흡곤란(44.8%), 발열(20.7%), 천명(13.8%), 흉통(10.3%) 및 객혈(0.4%) 순이었다. 흡인의 위험인자가 없는 환자의 92.8%가 증상이 발생한 반면 흡인 위험도가 높은 환자에서는 60%에서만 증상이 발생하였다(p=0.005). 또한 진단이 되기까지 증상 발생 기간이 각각 4일과 2일로 흡인 위험도가 높은 환자들에서 더 길었고(p=0.007), 3일 이내의 급성 호흡기 증상이 발생한 경우가 더 적었다(p=0.048). 6명(20.9%)의 환자가 단순 흉부 방사선에서 이상 소견이 없었던 반면 23명에서는 이물의 음영(11명), 폐렴(8명), air trapping(5명) 및 무기폐(3명) 등의 소견이 관찰되었다. 흡인의 위험도에 따른 기도 내 이물에 의한 방사선학적 특징에는 차이가 없었다. 흡인 위치로는 우측 기관지가 16예로 가장 많은 빈도를 보였고 우측 하엽 기관지가 가장 흔한 위치였다. 흡인 이물의 종류로는 치아가 11예로 가장 많은 빈도를 보였다. 흡인의 위험도가 높은 환자들에서 의학적 처기가 기도 내 이물 흡인이 발생하는 가장 흔한 경우였다. 모든 대상 환자의 기도 내 이물은 큰 부작용 없이 성공적으로 모두 제거되었으며 alligator jaw biopsy forceps이 이물 제거를 위해 가장 많이 사용되었다. 결론: 본 연구는 흡인의 위험도가 높은 환자에서는 이물 흡인의 과거력이 명확하지 않고 비전형적인 호흡기 증상을 보이는 경우가 많아 진단이 지연되거나 간과될 가능성이 높고 특히 의학적 처치 시 가장 많이 발생한다는 것을 보여주었다. 따라서 흡인의 위험성이 높은 환자에서 이물 흡인에 대한 적극적인 검사와 주의가 필요할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
• /
• 제40권4호
• /
• pp.442-448
• /
• 1993

저자들은 최근 약 30년전 치과에서 발치도중 치아 흡인되었으나 환자가 모르고 지내오다 5개월 전부터 시작된 좌상부 흉통을 주소로 내원, 폐엽절제술후 치아 흡인으로 인한 기관지폐쇄로 확인된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.