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RISS 인기검색어
- 검색키워드
- 저자 : Hongyeul Lee, M.D. (검색결과 9 건)
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( Hongyeul Lee ),( Ji Young Park ),( Taehoon Lee ),( Yeon Joo Lee ),( Hyo Jeong Lim ),( Jong Sun Park ),( Ho Il Yoon ),( Jae Ho Lee ),( Choon Taek Lee ),( Young Jae Cho ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.3
Background/Aims: Healthcare-associated pneumonia (HCAP) was proposed as a new pneumonia category in 2005, and treatment recommendations include broad-spectrum antibiotics directed at multidrug-resistant (MDR) pathogens. However, this concept continues to be controversial, and microbiological data are lacking for HCAP patients in the intensive care unit (ICU). This study was conducted to determine the rate and type of antibiotic-resistant organisms and the clinical outcomes in patients with HCAP in the ICU, compared to patients with community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). Methods: We conducted a retrospective cohort analysis of patients with pneumonia (n = 195) who admitted to medical ICU in tertiary teaching hospital from March 2011 to February 2013. Clinical characteristics, microbiological distributions, treatment outcomes, and prognosis of HCAP (n = 74) were compared to those of CAP (n = 75) and HAP (n = 46). Results: MDR pathogens were significantly higher in HCAP patients (39.1%) than in CAP (13.5%) and lower than in HAP (79.3%, p < 0.001). The initial use of inappropriate antibiotic treatment occurred more frequently in the HCAP (32.6%) and HAP (51.7%) groups than in the CAP group (11.8%, p = 0.006). There were no differences in clinical outcomes. The significant prognostic factors were pneumonia severity and treatment response. Conclusions: MDR pathogens were isolated in HCAP patients requiring ICU admission at intermediate rates between those of CAP and HAP.
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( Hongyeul Lee ),( Cho Sun Leem ),( Jae Ho Lee ),( Choon Taek Lee ),( Young Jae Cho ) 대한결핵 및 호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.77 No.4
Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.
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Lee, Hongyeul,Leem, Cho Sun,Lee, Jae Ho,Lee, Choon-Taek,Cho, Young-Jae The Korean Academy of Tuberculosis and Respiratory 2014 Tuberculosis and Respiratory Diseases Vol.77 No.4
Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.
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Perception of Long-Term Oxygen Therapy for Chronic Lung Diseases May Affect Poor Adherence in Korea
Hyun-Kyung Lee, M.D., Ph.D.,Hyo Jin Kim, M.D.,Hongyeul Lee, M.D.,Ji Young Yang, M.D.,Jae Ha Lee, M.D.,Seung Won Ra, M.D., Ph.D.,SungMin Hong, M.D.,Ho Young Lee, M.D.,Sung Hyun Kim, M.D.,Mi-Yeong Kim, 대한결핵및호흡기학회 2024 Tuberculosis and Respiratory Diseases Vol.87 No.1
Background: Long-term oxygen therapy (LTOT) improves the survival of patients withhypoxemia due to chronic respiratory diseases. The clinical outcomes of LTOT arestrongly associated with patient adherence. To improve the adherence of patients,physicians have focused on the efficacy of LTOT. However, poor adherence may stemfrom patients’ perceptions of LTOT. Herein we evaluated patients’ perceptions of LTOTaffecting adherence. Methods: We conducted a cross-sectional survey study using descriptive, open, andclosed-ended questionnaire. Patients using oxygen therapy (OT) or requiring it butavoiding OT responded to the questionnaires at three university hospitals. Results: Seventy-nine patients responded to the questionnaires. The number of patientsusing home and portable OT was 69 (93%) and 37 (46.3%), respectively. Patientswith good adherence were 22 (30.1%). Among patients with good adherence, 90.9%used oxygen according to physicians’ prescriptions whereas only 37.3% of those withpoor adherence followed physicians’ prescriptions (p<0.01). The reasons for avoidingusing home OT were fear of permanent use (50%), unwanted attention (40%), and lackof symptoms (40%). They avoided portable OT because of unwanted attention (39%),heaviness (31.7%), and lack of symptoms (21.6%). Conclusion: Patients on LTOT had the perception of the misunderstanding the effectsof OT and of psychosocial barriers to initiate or use LTOT. Considering these findings,health professionals need to provide effective education on the purpose of LTOT toimprove patient adherence to OT and provide sufficient support for the management ofpsychosocial barriers in patients using LTOT.
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Health-related quality of life in elderly population with diabetes mellitus.
( Hongyeul Lee ),( Hyun Min Kim ),( Jaetaek Kim ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Objective: This study aimed to investigate the relationship between diabetes mellitus and health-related quality of life (HRQoL) in elderly population, furthermore, the impact of comorbidities and glycemic control level on HRQoL in elderly patients with diabetes. Methods: Data from the 5th Korean National Health and Nutrition Examination Survey (KNHANES) of 2010-2012 were used in this study. Presence of comorbidities including hypertension, dyslipidemia, cardiovascular diseases, chronic kidney disease, chronic liver disease, chronic lung disease, and various types of cancer were analyzed. EuroQol 5D index score (EQ-5D) was used for assessment of health-related quality of life. Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group. Results: A total of 4742 subjects over 65 years of age (2031 men and 2711 women; mean age 72.9 ± 5.7 years) were included. Prevalence of diabetes mellitus was 22.7%, and prediabetes was 34.3% in this population. The mean EQ-5D score was lower in the diabetes group (0.84 ± 0.19) than the others (0.86 ± 0.18, p=0.001). The patients with diabetes had more comorbidities (1.73 ± 1.23) compared to those with normal glucose or prediabetes (1.09 ± 1.16, 1.42 ± 1.20, respectively). Among the 1076 patients with diabetes, EQ-5D score was associated with the numbers of comorbidities, however, there was no relationship with HbA1c level and EQ-5D score. In logistic analysis, age(OR 1.1, 95% CI, 1.1 to 1.2), male gender(OR 1.9, 95% CI, 1.3 to 2.8), and number of comorbidities(OR 1.4, 95% CI, 1.2 to 1.7) were associated with poor HRQoL, in contrast, HbA1c level, duration of diabetes, BMI, and treatment modality did not affect the HRQoL. Conclusions: Diabetes was associated with impaired HRQoL and multiple comorbidities in elderly population. Furthermore, in the elderly diabetic patients, glycemic control status was not associated with HRQoL, the degree of comorbid conditions was an important factor for defining HRQoL.
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Perception of Long-Term Oxygen Therapy for Chronic Lung Diseases May Affect Poor Adherence in Korea
( Hyo Jin Kim ),( Hongyeul Lee ),( Ji Young Yang ),( Jae Ha Lee ),( Seung Won Ra ),( Sungmin Hong ),( Ho Young Lee ),( Sung Hyun Kim ),( Mi-yeong Kim ),( Hyun-kyung Lee ) 대한결핵 및 호흡기학회 2024 Tuberculosis and Respiratory Diseases Vol.87 No.1
Background: Long-term oxygen therapy (LTOT) improves the survival of patients with hypoxemia due to chronic respiratory diseases. The clinical outcomes of LTOT are strongly associated with patient adherence. To improve the adherence of patients, physicians have focused on the efficacy of LTOT. However, poor adherence may stem from patients’ perceptions of LTOT. Herein we evaluated patients’ perceptions of LTOT affecting adherence. Methods: We conducted a cross-sectional survey study using descriptive, open, and closed-ended questionnaire. Patients using oxygen therapy (OT) or requiring it but avoiding OT responded to the questionnaires at three university hospitals. Results: Seventy-nine patients responded to the questionnaires. The number of patients using home and portable OT was 69 (93%) and 37 (46.3%), respectively. Patients with good adherence were 22 (30.1%). Among patients with good adherence, 90.9% used oxygen according to physicians’ prescriptions whereas only 37.3% of those with poor adherence followed physicians’ prescriptions (p<0.01). The reasons for avoiding using home OT were fear of permanent use (50%), unwanted attention (40%), and lack of symptoms (40%). They avoided portable OT because of unwanted attention (39%), heaviness (31.7%), and lack of symptoms (21.6%). Conclusion: Patients on LTOT had the perception of the misunderstanding the effects of OT and of psychosocial barriers to initiate or use LTOT. Considering these findings, health professionals need to provide effective education on the purpose of LTOT to improve patient adherence to OT and provide sufficient support for the management of psychosocial barriers in patients using LTOT.
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( Sung-min Hong ),( Hyun-kyung Lee ),( Ana Im ),( Sun Young Park ),( Ho-young Lee ),( Sung Hyun Kim ),( Hongyeul Lee ),( Mi-young Kim ),( Young-min Lee ),( Ji-yeon Han ),( Seok Jin Choi ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Introduction Eosinophilic lung disease (ELD) refers to a heterogeneous group of diseases characterized by peripheral blood eosinophilia, increased eosinophils in bronchoalveolar lavage (BAL) fluid, or lung tissue eosinophilia proven in lung biopsies. There have been several reports focusing only on one of the subtypes of ELDs. But epidemiologic data dealing with ELDs as a whole in Asian-Pacific region was not reported yet. Method We arbitrarily decided the definition of ELDs in our study as a BAL eosinophil fraction of 20% or higher with or without peripheral blood eosinophilia because consensus criteria of BAL eosinophilia for ELDs was not present. Among a total of 1,052 patients in which BAL and BAL cell count were done from 2010 to 2019 in our hospital, patients with ELDs were selected and their medical records were retrospectively reviewed. Result Total 56 patients of ELDs were found. 35 (62.5%) were male and the median age was 59 (18-85) years. The most common symptom was cough (42.9%), followed by dyspnea (23.2%), abnormal CT findings (14.3%), and dyspnea (n=5, 8.9%). Peripheral blood eosinophilia (> 500 eosinophil) was accompanied in about half of the patients. The chest CT findings were as follows; GGO (50.0%), GGO with consolidation (25.0%), consolidation (23.2%) and nodule (1.8%). The distribution of EDLs was as follows: chronic eosinophilic pneumonia (EP) (32%), acute EP (23%), ILD othe than AEP and CEP (21%), parasite infection (7%), and others (9%). Suspected causative parasitic organisms were Toxocara canis (2 out of 4) and Paragonimus westermani (2 out of 4). Most patients were treated by corticosteroid or anti-parasitic agents and were recovered without complication. Conclusion CEP and AEP were the most common causes of ELDs in our hospital for recent 10 years. Contribution of parasitic infection to ELDs was relatively small than expected. Prognosis were generally good.
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( Hyo Jin Kim ),( Sung Hyun Kim ),( Jun Hyeong Kim ),( Ji Young Yang ),( Hongyeul Lee ),( Young-min Lee ),( Hyun- Kyung Lee ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Introduction: Central venous catheterization is usually used for monitoring the cardiovascular state and administrating for fluids, total parenteral nutrition(TPN) and drugs. Extravasation of TPN by central venous catheter (CVC) is rare but fatal. CASE: A 70-year-old female underwent craniotomy and clipping in right posterior communicating artery for incidental aneurysmal formation. She was inserted a left subclavian CVC for surgery. After then she received fluid and antibiotics via subclavian CVC. In Post-operative day(- POD) 7, she had shortness of breath and had hypoxia with low blood pressure. Oxygen was supplied with nasal cannular and her blood pressure was recovered with inotropics. Chest radiography showed a large left-sided pleural effusion (Figure 1-1) and migrations of the CVC. A pigtail catheter was inserted immediately for effusion drainage. Pleural fluid analysis revealed a milky and triglyceride concentration was 465 mg/ dl and glucose was 207 mg/dl, the serum glucose was 98 mg/dl. A pleural fluid to serum glucose ratio >1 showed extravasation of TPN into her pleural space, which is not typical for chylothorax. Comparing the chest radiography POD1 with that of POD7, the migration of the CVC tip was seen (Figure 1-2). TPN was discontinued and the CVC was removed. Her symptoms and medical conditions were improved. After removing pigtail catheter at POD 13, there was no recurrence of pleural effusions and complications. Conclusion: We should have careful attention to the position of the CVC by radiography and be aware of this. These could be taken proper management immediately and reduced complication.
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