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- 저자 : ( Jim Yung Park ) (검색결과 4 건)
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( Jim Yung Park ),( Yeon Joo Lee ),( Jin Woo Lee ),( Sung Soo Park ),( Young Jae Cho ),( Sang Min Lee ),( Young Whan Kim ),( Sung Koo Han ),( Chul Gyu Yoo ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-
Background: ARDS is a clinical syndrome and has heterogeneous etiologies. Accurate diagnosis of specific etiology can lead to application of effective treatment. This study investigates clinical efficacy and safety of surgical lung biopsy in patients with ARDS. Methods: Patients with ARDS by Berlin definition and mechanical ventilatory support in ICU who underwent surgical lung biopsy in 3 hospitals from 2004 to 2013 were analyzed in retrospective cohort study. Data analyzed included baseline characteristics, pathologic diagnosis, treatment change, in-hospital mortality, and complication rate. Results: Total 84 patients with ARDS were enrolled in this study. Mean age was 58±16 years with PaO2/FiO2 of 132.1±54.5 mmHg. Diagnostic yield was 88.1%. Diffuse alveolar damage (DAD) was found in 31 patients (36.9%). The most common pathologic diagnoses other than DAD were infections. Biopsy finding led to treatment alteration in 48 patients (57.1%), however it did not result in significant survival benefit. The mortality in patients with DAD was not different from that in patients without DAD. Most of the postprocedural complications were mild, which occurred in 18 patients (21.4%) and there was no procedure related mortality. Conclusions: Surgical biopsy in ARDS has high diagnostic yield and its result can lead to clinically important treatment alteration with acceptable complication rate.
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( Jim Yung Park ),( Yeon Joo Lee ),( Jin Woo Lee ),( Sung Soo Park ),( Young Jae Cho ),( Sang Min Lee ),( Young Whan Kim ),( Sung Koo Han ),( Chul Gyu Yoo ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: ARDS is a clinical syndrome and has heterogeneous etiologies. Accurate diagnosis of specifi c etiology can lead to application of effective treatment. This study investigates clinical effi cacy and safety of surgical lung biopsy in patients with ARDS. Methods: Patients with ARDS by Berlin defi nition and mechanical ventilatory support in ICU who underwent surgical lung biopsy in 3 hospitals from 2004 to 2013 were analyzed in retrospective cohort study. Data analyzed included baseline characteristics, pathologic diagnosis, treatment change, in-hospital mortality, and complication rate. Results: Total 84 patients with ARDS were enrolled in this study. Mean age was 58±16 years with PaO2/fiO2 of 132.1±54.5 mmHg. Diagnostic yield was 88.1%. Diffuse alveolar damage (DAD) was found in 31 patients (36.9%). The most common pathologic diagnoses other than DAD were infections. Biopsy fi nding led to treatment alteration in 48 patients (57.1%), however it did not result in significant survival benefi t. The mortality in patients with DAD was not different from that in patients without DAD. Most of the postprocedural complications were mild, which occurred in 18 patients (21.4%) and there was no procedure related mortality. Conclusions: Surgical biopsy in ARDS has high diagnostic yield and its result can lead to clinically important treatment alteration with acceptable complication rate.
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( Hyung Jun Kim ),( Jim Yung Park ),( Jee Min Kim ),( Han Sol Choi ),( Jung Sil Lara Lee ),( Chang Hoon Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Lung involvement occurs more than 90 percent of sarcoidosis patients, with usual chest x-ray showing bilateral hilar lymphadenopathy and pulmonary infi ltrations. Here we present an unusual sarcoidosis case with multiple pulmonary nodules. Case Presentation: A 32-year old, previously healthy, 15 pack-year current smoker male presented with a 4-month history of masses in both neck and left elbow. He didn`t have any recent history of traveling. The chest X-ray showed bilateral hilar bulging appearance, with nodules in both lung fi elds. Chest computed tomography (CT) revealed multiple lymph node enlargements in both lower neck, mediastinum, axilla and abdomen, along with multiple well-defi ned nodules with variable size range from 0.5 to 3.5cm in both lungs. Both Sputum culture for mycobacteria and interferon gamma releasing assay showed negative. Results: Biopsy of his right neck lymph node was done, which showed chronic granulomatous infi ammation with very focal necrosis. He was initially treated with tuberculosis medications, but showed no improvement. He underwent biopsy once more, forone of lung nodules through percutaneous needle biopsy for pathologic confi rmation, which also showed chronic granulomatous infi ammation without necrosis. Baselineserum angiotensin converting enzyme (ACE) level was 49.5U/L. Thus, he was diagnosed as having sarcoidosis. His lung nodules and masses in neck and elbow have been improved without any treatment. Conclusions: We presented a case with sarcoidosis showing multiple pulmonary nodules, which has been rarely reported before. Sarcoidosis is a multi-organ disorder, and it can have nonspecifi c presentation of symptoms, clinical suspicion and appropriate pathologic confi rm is necessary to make a correct diagnosis.
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( Jee Min Kim ),( Ho Il Yoon ),( Yoon Jin Kwak ),( Hyung Jun Kim ),( Jim Yung Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: As part of social agenda to purify sewage and remove bad odor from river, EM(Effective Micro-organism) fermented liquor has been supplied by local government to citizens of Seong-nam from 2009. Its use has been broad including making soap, dish cleaner, humidifi er detergents, and cosmetics. We report a case of man who presented as impending respiratory failure after putting EM liquor inside humidifi er reservoir to inhale it. Case Presentation: A 68-year-old man who used EM fermented liquor inside vaporizerand inhaled it visited ER for dyspnea and fever. He presented shock with hypoxia and his chest CT showed bilateral upper lung fi eld GGO with septal line thickening. We carried out bronchoscopy with TBLB, and bronchoscopic washing specimen came outbloody with biopsy specimen consistent with diffuse alveolar hemorrhage. All microbiologic and virologic tests were negative. His symptoms and radiographic opacities had improved dramatically after several days of conservative care, and he was discharged healthy after a week of hospital stay. Conclusions: The use of EM liquor in humidifi er as vaporizing material might cause acute inhalation injury and could be fatal enough to cause respiratory failure. Cautions and recommendations for proper usage should be provided for its safe use, and furtherinvestigations should be performed to clarify relationships between EM liquor and its lung toxicities.
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