• 제목/요약/키워드: Asthma Patient

검색결과 161건 처리시간 0.028초

미만성 범세기관지염의 임상상에 관한 연구 (Clinical Characteristics of Diffuse Panbronchiolitis)

  • 김영환;유철규;한성구;심영수;김건열;한용철
    • Tuberculosis and Respiratory Diseases
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    • 제39권1호
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    • pp.28-34
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    • 1992
  • 연구배경 : 미만성 범세기관지염은 몽고계의 민족에 주로 주로 발생하는 만성호흡기 질환으로 아직 우리나라에서는 이 질환에 대한 인식이 적어 지금까지 발견된 환자수는 적으나 앞으로 많이 발생할 가능성이 있는 질환으로, 아직까지는 그 원인이 확실하지 않고 치료방법이 정립되지 않아 앞으로 이 질환에 대한 많은 관심과 연구가 필요할 것으로 생각된다. 저자들은 최근 2년간 서울대학병원에서 16명의 미만성 범세기관지염 환자를 진단하여 임상적 특정을 관찰하였다. 방법 : 미만성 범세기관지염 환자의 성별, 연령분포, 이환기간, 흡연력, 직업력, 과거병력을 조사하였으며, 증상, 이학적소견, 검사실소견을 분석하고 치료에 대한 반응을 검토하였다. 결과 : 1) 남녀비는 2.2 : 1 이였으며 연령은 27~72세(평균 48세)에 분포하였고, 질병이환기간은 1~20년(평균 7년)이었다. 2) 미만성 범세기관지염으로 진단받기 전 대부분의 환자가 기관지확장증, 속립성결핵, 만성기관지염, 기관지천식 등으로 치료받고 있었다. 3) 흡연력이 있는 환자는 1명 뿐이었으며, 분진 또는 가스 등의 직업력이 있는 환자는 4명(25%)이었다. 4) 모든 환자가 부비동염의 현증 또는 과거력이 있었다. 5) 모든 환자의 HRCT에서 미만성 범세기관지염에 특징적인 소견이 관찰되었다. 6) 폐기능검사상 폐쇄성 및 제한성 기능장애가 있었으며 폐확산능은 대부분 정상이었고, 동맥혈가스 검사에서는 저산소증이 있었으나 대부분의 환자에서 고탄산 혈증은 없었다. 7) 객담배양검사상 Pseudomonas aeruginosa가 4례(25%)에서 검출되었고, 혈청학적 검사에서는 cold hemagglutinin, RA factor 및 CRP가 높은 빈도에서 검출되었다. 8) 대부분의 환자가 erythromycin 치료에 반응하였다. 결론 : 미만성 범세기관지염은 우리나라에서 아주 드문 질환이 아닐 가능성이 있으므로 만성적인 기침, 객담, 호흡곤란이 있으며, 흉부 X선 사진상 미만성 소결절이 있는 환자에서는 일단 이 질환을 의심해보고, 필요하면 HRCT 및 개흉폐생검을 고려해야 할 것으로 생각한다.

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소아비연(小兒鼻淵)에 대(對)한 임상적(臨床的) 연구(硏究) (The Clinical Study of Biyun(sinusitis) in Children)

  • 박은정;이해자
    • 대한한방소아과학회지
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    • 제12권1호
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    • pp.111-131
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    • 1998
  • 1. In oriental medicine, the case of sinusitis can be explained, not only external invasion such as PUNG HAN(wind-cold), PUNG YUL(wind-hot), SHUP YUL(damp-heat), but also functional disorder of internal organ such as spleen(脾), lung(肺), kidney(腎) The western medicine classified the cause of sinusitis as two factors. That is bacterial infection factor-Haemophilus influenza, streptococcus pyogeues, streptococcus pneumonia- and viral infection factor-Rhinovirus, parainfluenza, Echo28, Coxsacki21, Sinusitis is complicated to allergic rhinitis, chronic otitis media purulent, chronic tonsilitis, sinubronchitis. On the condition of nasal septum deformity, turbinates deformity, nasal septum deviation, sinusitis can be developed. the predisposing factors of sinusitis is swimming, air pollution, malnutrition, shortage of immunity.2. According to survey, sinusitis occurred that children from 4 to 12 years old and from 5 to 7 years old occupied 70% 3. From the past history data, they experienced chronic tonsillar hypertropy(20%), otitis media, atopic dermatitis, allergic rhinitis, bronchial asthma, pneumonia, bronchiolitis, chronic sore throat, urticaria, milk allergy in sequence. 4. the symptoms of sinusitis is nasal obstruction, postnasal dripping, purulunt(yellow)or white discharge, cough, nose bleeding in sequence. nasal obstruction take the portion of 95%, postnasal dripping 65%, night time or early morning cough 60%. 5. The suffering period of sinusitis is 6 month minimum, 4 years maximum, most cases are included in a year. The suffering period of children was shorter than adult. 6. Diagnosis depend on inspection of nasal cavity, postnasal dripping, X-ray finding. 75% of patient(15case) showed both maxillary sinusitis, 25%(5cases) showed left or right maxillary sinusitis. 7. Treatment of oriental medicine, consist of Herb-medicine, acupuncture and exposing of Lazer beam. Kamihyunggyeyungyotang(加味荊芥蓮翹湯) is administered mainly as the medical therapy, Kamigwaghyangjeungkisan(加味藿香正氣散) Kimizwakwieum(加味左歸飮), Kamihyangsosan(加味香蘇散) is administered for a additional symptoms which occurred by influenza recurrence. Kamijeonxibackchulsan(加味錢氏白朮散) is administered to treat gastro-intestine trouble patients who have sinusitis. 8. The period of treatment is varied with patient conditions and X-ray finding. The minimal period is 35days, maximal period is 202days. So it took about 86days in average and about 50% of patient(10cases) is recovered in one or two month.

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Th17과 자가면역 관절염 (The Th17 and Autoimmune Arthritis)

  • 조미라;허유정;박진실;이선영;성영철;김호연
    • IMMUNE NETWORK
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    • 제7권1호
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    • pp.10-17
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    • 2007
  • Autoimmune arthritis, such as rheumatoid arthritis (RA), is a chronic inflammatory disorder that primarily affects the joints and then results in their progressive destruction. Effector Th cells have been classified as Th1 and Th2 subsets based on their cytokine expression profiles and immune regulatory function. Another subset of T cells termed Th17 was recendy discovered and known to selectively produce IL-17. Also, Th17 was shown to be generated by TGF${\beta}$ and IL-6 and maintained by IL-23. IL-17 is a proinflammatory cytokine that is considered to involve the development of various inflammatory autoimmune diseases such as RA, asthma, lupus, and allograft rejection. IL-17 is present in the sera, synovial fluids and synovial biopsies of most RA patient. IL-17 activates RA synovial fibroblasts to synthesize IL-6, IL-8 and VEGF via PI3K/Akt and NF-${\kappa}B$ dependent pathway. IL-17 increases IL-6 production, collagen destruction and collagen synthesis. In addition, it not only causes bone resorption but also increases osteoclastogenesis and fetal cartilage destruction. Inhibition of the IL-17 production may contribute a novel therapeutic approach along with potent anti-inflammatory effect and with less immunosuppressive effect on host defenses.

Mold Occurring on the Air Cleaner High-Efficiency Particulate Air Filters Used in the Houses of Child Patients with Atopic Dermatitis

  • Kim, Seong Hwan;Ahn, Geum Ran;Son, Seung Yeol;Bae, Gwi-Nam;Yun, Yeo Hong
    • Mycobiology
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    • 제42권3호
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    • pp.286-290
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    • 2014
  • Fungi are the known sources of irritation associated with atopic diseases (e.g., asthma, allergic rhinoconjunctivitis, and atopic eczema). To quantitatively estimate their presence in the indoor environment of atopic dermatitis-inflicted child patient's houses (ADCPHs), the high-efficiency particulate air (HEPA) filters installed inside the air cleaners of three different ADCPHs were investigated for the presence of mold. The air cleaner HEPA filters obtained from the three different ADCPHs were coded as HEPA-A, -B, and -C, respectively, and tested for the presence of mold. The colony forming units (CFUs) corresponding to the HEPA-A, -B, and -C filters were estimated to be $6.51{\times}10^2{\pm}1.50{\times}10^2CFU/cm^2$, $8.72{\times}10^2{\pm}1.69{\times}10^2CFU/cm^2$, and $9.71{\times}10^2{\pm}1.35{\times}10^2CFU/cm^2$, respectively. Aspergillus, Penicillium, Alternaria, Cladosporium, Trichoderma, and other fungal groups were detected in the 2,494 isolates. The distribution of these fungal groups differed among the three filters. Cladosporium was the major fungal group in filters HEPA-A and -C, whereas Penicillium was the major fungal group in the filter HEPA-B. Nine fungal species, including some of the known allergenic species, were identified in these isolates. Cladosporium cladosporioides was the most common mold among all the three filters. This is the first report on the presence of fungi in the air cleaner HEPA filters from ADCPHs in Korea.

수술이 힘든 고령의 직장-S상결장암 환자에 대한 알러젠 제거 옻나무 추출물 위주의 한방치료 1례 (A case report of inoperable rectosigmoid colon cancer treated with standardized Allergen-removed Rhus verniciflua Stokes Extract)

  • 권은미;정의홍;김경석;정현식;전성하;어완규;최원철;이상헌
    • 대한암한의학회지
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    • 제15권1호
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    • pp.63-69
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    • 2010
  • We report a case of an 85-year old man with an adenocarcinoma of the rectosigmoid colon (clinical stage II). Though tumor was resectable, the patient was considered to be inoperable because of old age and comorbidities such as asthma, diabetes and old myocardial infarction. He wanted to receive alternative care, so he was exclusively treated with standardized Allegern-removed Rhus verniciflua Stokes (aRVS) extract and other herbal medicine such as BOJUNGIKGI-TANG GAMIBANG. During 18 months, he has shown good performance status without transfusion. This report suggests that herbal treatment including standardized aRVS for rectosigmoid colon cancer could be an alternative treatment option when it is unabled to be treated by surgical resection.

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고액진료비 환자의 특성 비교분석 - 의료보험과 의료보호환자를 중심으로 - (Comparative Analysis on the Characteristics of High Cost Medical Users between the Health Insurance and Medical Assistance Program)

  • 강선희;문옥륜
    • 한국의료질향상학회지
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    • 제2권2호
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    • pp.112-129
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    • 1996
  • Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

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소아 만성 부비동염(副鼻洞炎)(축농증)의 한방치료효과 후 재발율에 대한 임상적 연구 (Clinical study for recurrence rate of the pediatric chronic sinusitis after herbal medicine therapy)

  • 이해자;박은정;양미라
    • 대한한방소아과학회지
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    • 제14권1호
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    • pp.117-126
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    • 2000
  • Background: In recent years, pediatric chronic sinusitis patients who didn't respond with antibiotics were increasing, but there were a few reports on recurrence rate of the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective: To know the recurrence rate of herbal medicine therapy in the chronic sinusitis using follow-up investigation. Materials and methods: Thirty four patients( 16 male and 18 female) treated in our hospital between December 1998 and August 1999 were studied. Ages ranged from 4 to 13 years (mean age :7.7 years). Twenty five patients(66%) had a underlying family history (allergy or sinusitis of family). In the past history, 32 patients (86%) had asthma, allergy of milk, atopic dermatitis, bronchiolitis and irritable bowel syndrome. Duration of treatment were from eleven to eighteen month (mean:14.3 month). Results: Of the 34 patients, 31 patients were improvement, 3 patients not. Of the 31 patients, thirty patients showed not recurrent (91%). Two patients showed no significant interval change(6%) and one patient was aggrevated (3%). The degree of the Health , thinking of protector for the herb medicine therapy and improvement of sinusitis were significant statistically. (significant <0.005) Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis.

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소세포폐암에서 Etoposide 투여 후 발생한 아나필락시스 1예 (A Case of Anaphylaxis after the Treatment with Etoposide in a Patient with Small Cell Lung Cancer)

  • 김영일;김규식;한의령;권용수;오인재;임성철;김영철
    • Tuberculosis and Respiratory Diseases
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    • 제67권2호
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    • pp.145-147
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    • 2009
  • Etoposide is a semi-synthetic derivative of podophyllotoxin that is effective against many cancers including small cell lung cancer. We report a case of etoposide-induced anaphylaxis in a 51-year-old woman who tolerated etoposide during her first cycle chemotherapy regimen. During the second cycle, she complained of generalized urticaria and dyspnea 5 minutes after being infused with etoposide. She recovered completely with antihistamine, corticosteroid and fluid replacement. The intradermal skin test with etoposide showed a clear positive immediate reaction. This case suggests that etoposide can induce IgE-mediated anaphylaxis.

소아 만성 부비동염(副鼻洞炎)(축농증)의 한방 치료효과 후 재발율에 대한 임상적 연구 (Clinical Study for recurrence rate of the pediatric chronic sinusitis after Herbal Medicine therapy)

  • 이해자;박은정;양미라
    • 대한한방소아과학회지
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    • 제15권1호
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    • pp.59-70
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    • 2001
  • Background : In recent years, pediatric chronic sinusitis patients who didn't respond with antibiotics were increasing, but there were a few reports on recurrence rate of the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective : To know the recurrence rate of herbal medicine therapy in the chronic sinusitis using follow-up investigation. Materials and methods : Thirty four patients(16 male and 18 female) treated in our hospital between December 1998 and August 1999 were studied. Ages ranged from 4 to 13 years (mean age :7.7 years). Twenty five patients(66%) had a underlying family history (allergy or sinusitis of family). In the past history, 32 patients (86%) had asthma, allergy of milk, atopic dermatitis, bronchiolitis and irritable bowel syndrome. Duration of treatment were from eleven to eighteen month (mean:14.3 month). Results : Of the 34 patients, 31 patients were improvement, 3 patients not. Of the 31 patients, thirty patients showed not recurrent (91%). Two patients showed no significant interval change(6%) and one patient was aggrevated(3%). The degree of the Health, thinking of protector for the herb medicine therapy and improvement of sinusitis were significant statistically. (significant <0.005) Conclusion : We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis.

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심한 호흡곤란을 보인 다발성 소결절성 폐질환 (Multiple Small Nodular Lung Lesions with Severe Dyspnea)

  • 양석철;이경상;윤호주;신동호;박성수;이정희;함시영;이철범
    • Tuberculosis and Respiratory Diseases
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    • 제43권2호
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    • pp.285-290
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    • 1996
  • 저자들은 특징적인 임상 증상과 함께 전형적인 흉부 x-선 및 고해상 흉부 전산화 단층 촬영을 보이는 미만성 법세기관지염 환자에서 흉강경을 이용한 폐생검으로 확진하여 erythromycin 소량 투여로 임상적 효과를 얻은 1예를 문헌 고찰과 함께 보고는 바이다.

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