PURPOSE: This study was to evaluate the effect of flexible bronchoscopy for the treatment of secondary atelectasis of children following respiratory infection. METHODS: The medical records for a total of 19 cases of flexible bronchoscopy were reviewed retrospectively, which were performed for the treatment of secondary atelectasis at the Department of Pediatrics of the Catholic University of Korea Seoul St. Mary's Hospital from April 2007 to January 2013. RESULTS: A total of 18 patients (11 males and 7 females) were involved in the study. The range of age was 4 months to 15 years old. The causative underlying diseases were 17 cases of pneumonia, 1 case of bronchiolitis and 1 case of bronchial asthma. The most common location of atelectasis was right middle lobe and right middle lobe with left lower lobe was next. Bronchoscopy revealed inflammatory changes in 12 cases (63.2%) such as mucus plug (n=4), profuse secretion (n=4), mucosal edema (n=3), and bronchial narrowing (n=1), although 7 cases (36.8%) showed normal airway. Other additional findings were bronchomalacia, tracheomalacia, and bronchial tree abnormality. Seven out of 19 cases who received therapeutic intervention had complete or partial reexpansion of their atelectasis. Cases who occurred atelectasis within 6 weeks showed significantly higher improvement than cases occurred after 6 weeks (70% vs. 11.1%, P=0.019). Complications including seizure, fever, hypoxia, mucous bleeding, and hypotension were observed in 6 cases. CONCLUSION: Flexible bronchoscopy revealed to be effective and safe treatment modality in treatment of secondary atelectasis of children. Timely therapeutic intervention in pediatric patients should be considered.
Anoxia ; Asthma ; Bronchiolitis ; Bronchomalacia ; Bronchoscopy ; Child ; Edema ; Hemorrhage ; Humans ; Hypotension ; Korea ; Male ; Medical Records ; Mucus ; Pediatrics ; Pneumonia ; Pulmonary Atelectasis ; Retrospective Studies ; Seizures, Febrile ; Tracheomalacia

Covid-19 which was first documented in the Philippines in January 2020 had spread alarmingly. Severe acute respiratory symptoms were the most common presentation of this novel coronavirus infection. Reports have described neurologic manifestations of this disease involving the central nervous system as well as the peripheral nervous system. However, studies among the pediatric population are limited. In this paper, we present three pediatric patients who were diagnosed with COVID-19, via RT-PCR, presenting with seizures and behavioral changes. Two of these patients have no concomitant respiratory symptoms while the other one had Pediatric Community Acquired Pneumonia. These patients were managed as cases of acute viral meningoencephalitis and were given supportive care.

PURPOSE: To assess the relationship between the complications of mycoplasma pneumonia and titers of cold agglutinin and mycoplasma antibody in children. METHODS: 120 cases of mycoplasmal pneumonia in children who were admitted to the Pediatric Department of Kwangju Christian Hospital between June 1993 and May 1994 were analyzed. RESULTS: 1) The peak incidence of age was between 2 and 6 years, and the sex ratio of boy to girl was 1 : 1.1. 2) Chest X-ray examinations revealed that the most common type of pneumonia was bronchopneumonia(51 cases, 42.5%); unilateral involvement was common(60.8%); and the lower lobe was the most commonly involved(50 cases, 41.6%). 3) Pulmonary complications were sinusitis in 43 cases(35.8%), followed by atelectasis in 24, pleural effusion in 18, asthma in 15, pharyngitis in 9, laryngitis in 4 and Swyer- James syndrome in 1 case. 4) Extrapulmonary complications were hepatitis in 12 cases, proteinuria in 7, hematuria in 5, convulsion in 3, psychosis in 3 and nephrotic syndrome, encephalitis and disseminated intravascular coagulation in 1 each. 5) No significant relationships were found between the duration of pneumonia and cold agglutinin titer, and between the duration of pneumonia and mycoplasma antibody titer(p>0.05). 6) The occurrence rate of the complications was not related to cold agglutinin titer(r=0.291); but it was significantly related to mycoplasma antibody titer(r=0.764), i.e., the higher the mycoplasma antibody titer, the higher incidence of complications. CONCLUSIONS: The occurrence rate of complications of mycoplasma pneumonia was not related to cold agglutinin titer, but it was significantly correlated with mycoplasma antibody titer.
Asthma ; Child* ; Disseminated Intravascular Coagulation ; Encephalitis ; Female ; Gwangju ; Hematuria ; Hepatitis ; Humans ; Incidence ; Laryngitis ; Male ; Mycoplasma* ; Nephrotic Syndrome ; Pharyngitis ; Pleural Effusion ; Pneumonia ; Pneumonia, Mycoplasma* ; Proteinuria ; Psychotic Disorders ; Pulmonary Atelectasis ; Seizures ; Sex Ratio ; Sinusitis ; Thorax

BACKGROUND: Rhabdomyolysis is a serious and potentially lethal condition that can develop from a variety of nontraumatic causes. Recently, there have been several reports about rhabdomyolysis which developed after alcohol abuse, drug intoxication, or vigorous exercise, but no report about all spectrums of nontraumatic rhadomyolyis in Korea. So we undertook this study to evaluate the clinical characteristics and course of nontraumatic rhabdomyolysis in a single medical center. METHODS: Several clinical and laboratory data were collected and analyzed in 68 patients with nontraumatic rhabdomyolyis from January 2002 to December 2003. RESULTS: The patients consisted of 58 males and 10 females with mean age of 48.0 +/- 16.3 years. The etiologic factors of nontraumatic rhabdomyolysis were as follows: 21 cases of alcohol abuse (30.9%), 13 cases of muscle ischemia (19%), 9 cases of shock (13%), 7 cases of infection, 6 cases of drug intoxication, 3 cases of seizure, 2 cases of malignant hyperthermia, 2 cases of diabetic ketoacidosis, 1 case of vigorous exercise, 1 case of CO poisoning, 1 case of hypophosphatemia, and 2 cases of unknown causes. Among the 68 patients, forty four patients (64%) developed acute renal failure and seventeen patients (25%) died of sepsis, acute respiratory distress syndrome, pulmonary edema or underlying diseases exacerbation. Among the 44 patients in acute renal failure, eighteen patients (41%) had oliguria during follow-up period. Thirteen patients of them needed dialysis and sixteen patients of them (36.4%) died. Another developed complications were hepatic dysfunction (34%), disseminated intravascular coagulation (28%), hypocalcemia (28%), acute respiratory distress syndrome (26%), pneumonia (22%), pulmonary edema (21%), hyperphosphatemia (7%) and hyperkalemia (4%). CONCLUSION: Nontraumatic rhabdomyolysis with acute renal failure is a serious and potentially lethal condition. Optimal treatment depends on early recognition and intervention. A high clinical suspicion for the occurrence of rhabdomyolysis in the nontraumatic conditions can lead to quicker recognition and better patient care.
Acute Kidney Injury ; Alcoholism ; Diabetic Ketoacidosis ; Dialysis ; Disseminated Intravascular Coagulation ; Female ; Follow-Up Studies ; Humans ; Hyperkalemia ; Hyperphosphatemia ; Hypocalcemia ; Hypophosphatemia ; Ischemia ; Korea ; Male ; Malignant Hyperthermia ; Oliguria ; Patient Care ; Pneumonia ; Poisoning ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult ; Rhabdomyolysis ; Seizures ; Sepsis ; Shock

Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).
Blood Pressure ; Consciousness ; Emergency Service, Hospital ; Female ; Glycosuria ; Herbicides ; Humans ; Hypnotics and Sedatives ; Incidence ; Intention ; Leukocytosis ; Male ; Miosis ; Mortality ; Nausea ; Pesticides ; Physical Examination ; Pneumonia ; Pulmonary Edema ; Pupil ; Respiratory Insufficiency ; Rodenticides ; Seasons ; Seizures ; Suicide ; Sweat ; Sweating ; Vomiting

PURPOSE: The incidence of infectious disease, which has been the cause of death in pediatric period, was decreased. But, the opportunistic exposure to toxic substance shows a tendency to increase. We performed this study in order to find out preventive measures and the latest inclination of acute poisoning in childhood. METHODS: From January 1985 to July 1996, 88 children with acute drug and chemical poisoning, who diagnosed at Presbyterian Medical Center, were analyzed retrospectively. RESULTS: 1) It occurred more frequently in male than female (1.7:1) and high incidence was noted in 0-4 year-old age group (75%). 2) Annual distribution of poisoning shows a tendency to increased. 3) There was no significant seasonal difference in frequency of poisoning. 4) The vast majority (85%) of poison exposure were accidental and therapeutic intent was present in 7.5% of cases and suicidal intent was 7.5% of cases. 5) We noticed an hourly predominance with most accidents occurring from 9 a.m. to 1 p.m. and from 5 p.m. to 9 p.m., 35% respectively. 6) Categories with the largest numbers of total exposure, in descending order by exposure frequently, include the following : drug (30.1%), insecticide (20.4), rodenticide (12.9%), glacial acetic acid (13.9%), herbicide (4.3%), Carbon monoxide (3.2%), others (13%). So, food and household material are leading cause of poisoning, except drug. Of drug, DDS was the most common and then psychotherapeutic drugs were the next. 7) The chief complaints on admission were nausea and vomiting (32%), mental change (26%) irritability (9%), peripheral cyanosis (8%), seizure (5%), and in case of 20%, the patient were found incidentally without symptoms. 8) There were complications which were pneumonia, pulmonary fibrosis, esophageal stricture and pneumothorax. And death occurred in 4 cases, due to insecticide (2 cases), herbicide and rodenticide, 1 case respectively. CONCLUSIONS: In previous report in Korea, causative substance of poisoning were drug, carbone monoxide, insecticide, rodenticide in descending order. In our study, drug was the most common cause of poisoning. But it' s proportion was decreased compared with previous report, and carbone monoxide intoxication was markedly decreased. But, we noticed that the proportion of household material, such as glacial acetic acid and other household chemical, was increased. So, we should be pay more attention to poisoning and try to prevent them.
Acetic Acid ; Carbon ; Carbon Monoxide ; Cause of Death ; Child ; Communicable Diseases ; Cyanosis ; Esophageal Stenosis ; Family Characteristics ; Female ; Humans ; Incidence ; Korea ; Male ; Nausea ; Pneumonia ; Pneumothorax ; Poisoning* ; Protestantism ; Pulmonary Fibrosis ; Retrospective Studies ; Seasons ; Seizures ; Statistics as Topic* ; Vomiting

STUDY DESIGN: Retrospective. OBJECTIVES: To investigate factors related to early postoperative complications of surgery for cervical spondylotic myelopathy (CSM). SUMMARY OF LITERATURE REVIEW: Factors associated with increased risk of complications from surgery for CSM are greater age, greater estimated blood loss, longer operative duration, and anterior-posterior combined procedures. MATERIALS AND METHODS: The records of patients (male 32, female 19, mean age 61 years) who underwent surgery for CSM between November 2004 and December 2014 were investigated for early postoperative complications and potentially related factors. Factors considered were age, gender, duration of symptoms, diabetes, smoking, comorbidity, preoperative Japanese Orthopedic Association (JOA) score, numbers of cervical levels involved, ossification of the posterior longitudinal ligament (OPLL), operative approach, fusion, operative duration, estimated blood loss (EBL), maximal cord compression ratio on MRI, and cord signal intensity change on T2-weighted MRI. RESULTS: Early postoperative complications were observed in 12 of 51 patients and included motor weakness in 3, pneumonia in 2, and delirium, dysphagia, hematoma, pulmonary thromboembolism, sore, seizure, wound dehiscence, and superficial infection, each in 1. Factors associated with early postoperative complications were operative duration (p=0.024), maximal cord compression ratio on MRI (p=0.009), and cord signal intensity change on T2-weighted MRI (p=0.009). The other factors were not found to correlate significantly. CONCLUSIONS: Factors associated with early postoperative complications for CSM are operative duration, compression ratio at the level of maximal cord compression on MRI, and cord signal intensity change on T2-weighted MRI.
Asian Continental Ancestry Group ; Comorbidity ; Deglutition Disorders ; Delirium ; Female ; Hematoma ; Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Orthopedics ; Pneumonia ; Postoperative Complications* ; Pulmonary Embolism ; Retrospective Studies ; Seizures ; Smoke ; Smoking ; Spinal Cord Diseases* ; Wounds and Injuries

Background ; Carbon Monoxide is colorless, ordorless, highly toxic gas produced by fire and by motor vehicles and appliances which use carbon-based fuels. In Korea, since coals were the main domestic fuel for cooking and for heating the floor, many cases of carbon monoxide intoxication have occurred annually. Until now, systemic complications & clinical manifestations as well as neurologic complications following carbon monoxide poisoning have rarely been reported. METHODS: I have researched systemic complications and clinical manifestations including neurologic complications from 1986 to 1997. I reviewed retrospectively medical records of 188 admitted patients to the Yonsei Medical Center due to carbon monoxide intoxication, and analyzed them according to the neurological, cardiovascular, respiratory, urogenital, dermatological and other systems. RESULTS: 1)The number of the admitted patients due to CO intoxication to Yonsei Medical Center between 1986 and 1997 has decreased compared to that between 1976 and 1981. 2)In this study, the cause of CO intoxication were furnaces in 170 cases(93.9%), fire accidents in 2 cases(1.1%), gas boilers in 2 cases(1.1%), LPG gas in 1 case(0.55%) and propan gas in 1 case(0.55%) in order. 3)Systemic complications and clinical manifestations after CO intoxication were 167(88.8%) nervous , 59(31.4%) musculoskeletal, 56(29.8%) respiratory, 49(26%) dermatologic, 44(23.4%) cardiovascular, 30(16.0%) genitourinary and 9(4.8%) other complications. Other systemic complications as well as neurological complications were not rare. 4)The clinical manifestations of neurological complications were decreased mental status(drowsy in 57 cases(30.3%), stupor in 63 cases(33.5%), semicoma in 33 cases(17.6%), coma in 13 cases(6.9%), alert in 22 cases(11.7%), focal sign related to the stroke in 16 cases (7.4%), incontinence in 22 cases(11.7%), seizure in 4 cases(2.4%), psychiatric behavior in 4 cases(2.4%), peripheral neuropathy in 4 cases(2.4%), bracheal plexopathy in 4 cases(2.4%), and torticollis in 1 case(0.5%). Delayed neurologic sequelae were akinetic mutism in 13 cases(76.5%), mental deterioration in 6 cases(35.3%), incontinence in 6 cases(35.3%), psychiatric behavior in 3 cases(17.6%), speech disturbance in 2 cases(11.8%), involuntary movement in 2 cases(11.8%), and depression in 1 case(5.9%) in order. 5)Cardiovascular complications showed tachycardia in 47 cases(28.3%), ischemic heart disease in 34 cases(18.6%), right bundle branch block in 6 cases(3.6%), left axis deviation in 4 cases(2.4%), atrial fibrillation in 3 cases(1.8%), sinus arrhythmia in 2 cases(1.2%), premature atrial contraction in 1 case(0.6%), premature ventricular contraction in 1 case(0.6%), primary atrio-ventricular block in 1 case(0.6%), prolonged QT in 1 case(0.6%). 6)Pulmonary complications were pneumonia in 23 cases(13.1%), pulmonary edema in 22 cases(12.6%), pneumonia with pulmonary edema in 3 cases(1.7%), and atelectasis, pulmonary hemorrhage, empyema, pleurisy in each 1 case(0.6%). 7)Azotemias were 26 cases(14.2%), clinically confirmed acute renal failures were 4 cases(2%) 8)Rhabdomyolysis was not rare as 63 cases(33.5%) compared to the previous report. 9)Dermatologic complications were erythema with bullae in 21 cases(11.9%), erythema without bullae in 14 cases(7.9%), bullae only in 10 cases(5.6%), laceration in 3 cases(1.65%), and ulceration in 1 case(0.55%). Conclusion ; We must consider other systemic manifestations as well as neurological symptoms in patients with CO intoxication since those are not infrequent in Korea.
Acute Kidney Injury ; Akinetic Mutism ; Arrhythmia, Sinus ; Atrial Fibrillation ; Atrial Premature Complexes ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Carbon Monoxide Poisoning ; Carbon Monoxide* ; Carbon* ; Coal ; Coma ; Cooking ; Depression ; Dyskinesias ; Empyema ; Erythema ; Fires ; Heating ; Hemorrhage ; Hot Temperature ; Humans ; Korea ; Lacerations ; Medical Records ; Motor Vehicles ; Myocardial Ischemia ; Penicillin G Benzathine ; Peripheral Nervous System Diseases ; Pleurisy ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Edema ; Retrospective Studies ; Seizures ; Stroke ; Stupor ; Tachycardia ; Torticollis ; Ulcer ; Ventricular Premature Complexes