• Pediatric Infection and Vaccine
• /
• v.10 no.1
• /
• pp.114-122
• /
• 2003

Acute transverse myelitis is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic dysfunction which would be the initial manifestation of acute disseminated encephalomyelitis. A 7-year-old boy developed weakness of lower extremities associated with dizziness and urinary dysfunction after upper respiratory infection. He showed gradual decreased mental status with respiratory difficulty. Spinal MRI showed diffuse spinal cord swelling from C3 to C7 levels with high signal intensity lesion on T2-weighted image, which is involved central gray matter of spinal cord from C3 to C7, proximal portion to cervicomedullary junction, and distal portion to the cornus medullaris. After the supplement of high dose intravenous methylprednisolone therapy with ventilator care, he showed gradual improvement. The brain MRI after extubation showed multifocal high signal intensity lesions in bilateral cerebral white matter on axial T2-weighted image. Immunoserologic test(neutral antibody test) for enterovirus 71 was positive. Dysfunction of the bladder lasted for 33 days. We report a case of transverse myelitis which progressed to acute disseminated encephalomyelitis by enterovirus 71 in a 7-year-old boy with related literatures.

• Journal of Chest Surgery
• /
• v.48 no.4
• /
• pp.289-293
• /
• 2015

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

• Tuberculosis and Respiratory Diseases
• /
• v.80 no.4
• /
• pp.351-357
• /
• 2017

In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.

• Clinical and Experimental Pediatrics
• /
• v.58 no.6
• /
• pp.224-229
• /
• 2015

Purpose: Thyroid dysfunction is common in preterm infants. Congenital hypothyroidism causes neurodevelopmental impairment, which is preventable if properly treated. This study was conducted to describe the characteristics of thyroid dysfunction in very low birth weight infants (VLBWIs), evaluate risk factors of hypothyroidism, and suggest the reassessment of thyroid function with an initially normal thyroid-stimulating hormone (TSH) as part of a newborn screening test. Methods: VLBWIs (January 2010 to December 2012) were divided into two groups according to dysfunction-specific thyroid hormone replacement therapy, and associated factors were evaluated. Results: Of VLBWIs, 246 survivors were enrolled. Only 12.2% (30/246) of enrolled subjects exhibited thyroid dysfunction requiring thyroid hormone replacement. Moreover, only one out of 30 subjects who required thyroid hormone treatment had abnormal thyroid function in the newborn screening test with measured TSH. Most of the subjects in the treatment group (22/30) exhibited delayed TSH elevation. Gestational age, Apgar score, antenatal steroids therapy, respiratory distress syndrome, patent ductus arteriosus, sepsis, intraventricular hemorrhage, postnatal steroids therapy, and duration of mechanical ventilation did not differ between the two groups. Birth weight was smaller and infants with small for gestational age were more frequent in the treatment group. Conclusion: Physicians should not rule out suggested hypothyroidism, even when thyroid function of a newborn screening test is normal. We suggest retesting TSH and free thyroxine in high risk preterm infants with an initially normal TSH level using a newborn screening test.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.9 no.1
• /
• pp.43-46
• /
• 1998

Background and Objectives : Singers, the vocal equivalents of Olympic athletes, may present with vocal dysfunction in the singing voice before adverse effects are noted in the speech mode. For the classically trained singers, any imbalance in the respiratory, laryngeal or resonatory subsystems may manifest first in technical compensations. Therefore it is necessary that baseline values be available in order to differentiate technique related dysfunction from abnormalities within the phonatory system. Materials and Methods : Vocal efficiency measures were collected from 55 classically trained singers and 20 untrained adults. All singers was divided into 3 groups : (1) Singers who have normal larynx with out voice symptoms. (2) Singers who have vocal nodule without voice symptoms. (3) Singers who have vocal nodule with voice complaints. Results and Conclusion : Results were compared with each other. Differences in each group wert found, suggesting the need for separate normative data to be used for the evaluation of the classically trained singers.

• Tuberculosis and Respiratory Diseases
• /
• v.58 no.1
• /
• pp.83-88
• /
• 2005

Leflunomide is a new disease modifying anti rheumatic drug (DMARD) for the treatment of active rheumatoid arthritis. Its mechanism of action differs from other DMARDs in that it inhibits the de novo pyrimidine synthesis by inhibiting dihydroorotate dehydrogenase and therefore prevents the proliferation of activated lymphocytes. As it has been prescribed worldwide, there is a great deal of much concerns regarding its potential adverse effects. Because leflunomide has an active metabolite with a long elimination half-life of approximately 2 weeks, serious adverse reactions may occur even after the leflunomide treatment has been stopped. The profile of serious reactions includes liver dysfunction, hematological disorders, severe skin reactions and respiratory dysfunction. Respiratory dysfunctions with leflunomide therapy are very rare and its incidence is lower than that of methotrexate therapy. However, there are reports in Japan showing that 5 patients died of interstitial pneumonitis and another 11 patients developed serious lung complications associated with leflunomide. This suggests the possibility of fatal respiratory toxicity of leflunomide. There are no reports of interstitial pneumonitis associated with leflunomide in Korea. We report a case of a 62-year old woman who developed interstitial pneumonitis, which might have been induced by leflunomide during the treatment of rheumatoid arthritis.

• The Journal of the Korean dental association
• /
• v.51 no.9
• /
• pp.511-517
• /
• 2013

To assess the association between oral health and general health, this study examined the relationship between chewing difficulty and twelve chronic health conditions such as hypertension, hyperlipidemia, diabetes, cerebro- and cardiovascular disease, musculoskeletal disease, respiratory disease, eye/nose/throat disease, stomach/intestinal ulcer, renal dysfunction, thyroid disease, depression, and cancer in Korea. The study population was 3,066 elders aged 65 years old and more from the fourth Korean National Health and Nutrition Examination Survey. Chewing difficulty was measured on a 5-point Likert scale. Chronic conditions were assessed by self-reported questionnaire. Confounders were age, gender, education, income, smoking, drinking, and obesity. Chi-square test, general linear model, and multiple logistic regression model were done with complex sampling design. Musculoskeletal disease (adjusted odds ratio=1.33), respiratory disease (adjusted odds ratio=1.52), and cancer (adjusted odds ratio=1.58) were independently associated with chewing difficulty. Multiple chronic conditions with more than 4 chronic disease showed significant association with chewing difficulty (adjusted odds ratio=1.37).

• The Journal of Internal Korean Medicine
• /
• v.24 no.4_2
• /
• pp.1087-1092
• /
• 2003

Paraquat is a non-selective contact herbicide. When it is consumed, it may cause fatal disorders such as acute renal failure, hepatic dysfunction, and progressive respiratory failure. In spite of many efforts to cure patients poisoned with paraquat, the mortality rate still remain high. In this case, after using Gamdutanghaphwangryunhaedoktang-gamibang and Cheongsangboha-tang we got positive result in hepato-renal function, but progressive respiratory failure was unstoppable.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.3
• /
• pp.178-181
• /
• 2012

Streptococcus suis causes meningitis and sepsis in pigs, but human infection has increased over the past few years in those who are exposed to pigs or raw pork. Most cases have occurred in Southeast Asia, but only two cases have been reported in South Korea, presenting with arthritis and meningitis. Here, we report a rare case of S. suis infection, a 60-year-old sailor, who visited the emergency room presenting septicemia, pneumonia with empyema and meningitis, showed full recovery; however, neurologic sequale of severe cognitive dysfunction was present after the usage of antibiotics and percutaneous drainage. S. suis was isolated from blood and pleural fluid and the strain was susceptible to penicillin and vancomycin. Increased awareness of S. suis infection and prevention are warranted.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.6
• /
• pp.651-656
• /
• 2002

Hyperimmunoglobulin E syndrome, otherwise known as Job's syndrome, is an immune disorder characterized by an abnormal elevation of the circulating immunoglobulin E level, and recurrent infections of the skin and sinopulmonary tract. The syndrome has various pulmonary features, e.g., pneumonia, pneumatocele, pneumothorax, lung abscesses and empyema. We report a case of hyperimmunoglobulin E syndrome, with various respiratory clinical manifestation. Medical therapy, including prophylactic antibiotics, has been the cornerstone for the treatment of hyperimmunoglobulin E syndrome. Even if surgical intervention is required, minimal pulmonary parenchymal resection is recommended.