• Title/Summary/Keyword: Asthma Patient

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A Case of Endobronchial Chondroma (좌측 주기관지에 발생한 연골종 1예)

  • Kim, Young-A;Jung, Jae-Han;Chang, Yoon-Soo;Kim, Hyung-Jung;Ahn, Chul-Min;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.78-83
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    • 2000
  • Endobronchial chondroma is a cartilaginous benign tumor, which arises from bronchial cartilage. As a rare benign tumor, endobronchial chondroma differs from cartilaginous hamartoma in that it includes cartilage components only, but hamartoma contains lipomatous and lymphoid tissue. The clinical manifestations of endobronchial chondroma are associated with the extent of mechanical obstruction of bronchus. Symptoms of endobronchial chondroma are nonspecific, such as cough, sputum, fever, or dyspnea on exertion. Endobronchial chondroma is often misdiagnosed as other diseases, such as asthma, chronic obstructive pulmonary disease, or pulmonary tuberculosis. The treatment is usually surgical procedures, such as resection of lung segment or lobe by thoracostomy, or resection of tumor by bronchoscopy. We report a case of the patient who was diagnosed to have endobronchial chondroma treated by bronchial resection and end to end anastomosis.

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Development of Transdermal Delivery Systems Containing Clenbuterol (클렌부테롤 경피흡수제제의 개발)

  • Choi, Han-Gon;Quan, Qi-Zhe;Jung, Si-Young;Rhee, Jong-Dal;Yong, Chul-Soon
    • Journal of Pharmaceutical Investigation
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    • v.30 no.4
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    • pp.247-252
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    • 2000
  • The advantages of transdermal administration are avoiding hepatic first pass effect, minimizing inter- and intra-patient variation, maintaining steady-state plasma level to provide long-term therapy from a single dose, and allowing a rapid termination of drug input. Clenbuterol, a selective ${\beta}_2-adrenergic$ receptor stimulant, has been introduced as a potent bronchodilator for patients with bronchial asthma, chronic obstructive bronchial disease. For the development of transdermal systems containing clenbuterol, two limiting factors - long lag time and low flux - must be overcome. In this study, we attempted to select optimal formulation for preparation of clenbuterol patch using hairless mouse skin and flow-through diffusion cell. The flux of clenbuterol increased as the percent of clenbuterol dose dependently in the concentration range of 5-15%. Based on this result, we fixed the concentration of clenbuterol as 15%. The effect of various penetration enhancers on percutaneous absorption of clenbuterol through hairless mouse skin was investigated. Labrafil was the most effective enhancer, which increased the permeability of clenbuterol approximately 4-fold compared with the control without penetration enhancer. Optimal enhancer concentration was 3%. The effect of various adhesives on penetration of clenbuterol was also investigated. Among the adhesives studied, MA-31 was the most effective adhesive. Furthermore, the clenbuterol patch composed of 15% clenbuterol, 3% Labrafil and 82% MA-31, which gave most excellent penetration of drug in in vitro penetration study, maintained therapeutic plasma levels in in vivo study using S.D. rats. These studies demonstrated a good feasibility of clenbuterol administration through the intact skin using a transdermal patch, and show a possibility of the development of clenbuterol patches.

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Association with Genetic Polymorphism of rs117033348 and Allergic Disease in Korean Population

  • Kong, Yoonji;Kim, Mingyeong;Jin, Hyun-Seok;Park, Sangjung
    • Biomedical Science Letters
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    • v.27 no.3
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    • pp.177-181
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    • 2021
  • Allergy is an immune response that appears in certain people, and reactions such as coughing, shortness of breath, and hives occur. The immune system plays an important role in homeostasis and host defense, and allergies cause hypersensitivity reactions when an imbalance of immunity occurs. Mutations in the TLR genes are associated with autoimmune conditions such as allergies and asthma. It has been reported that a locus in the TLR1-TLR6-TLR10 region may be associated with atopic sensitization or allergy. Therefore, the purpose of this study was to select an allergy patient group and a healthy control group to determine how the genetic mutation of TLR1 affects the onset of disease. This study was conducted in 709 patients and 5,025 control groups out of 10,956 patients with data from KARE and HEXA cohorts. As a result of logistic regression analysis of 6 SNPs selected from the TLR1 gene, only rs117033348 showed a statistically significant correlation (P = 0.002356). The influence of rs117033348 was examined using PolyPhen-2, and a significant result was shown. Therefore, it can be predicted that the G base in rs117033348 will have an influence on the human body. In addition, Geography of Genetic Variants browser was used to confirm the geographical distribution of allele frequencies for the TLR1 gene. Although it was found that there was a large racial difference in the prevalence of TLR1 SNP, it could be confirmed that the polymorphism of rs117033348 conducted in this study was only specific in East Asia when compared with each race.

A Study of the Nutritional Status According to the State of Depression of Allergic Disease Patients: Based on the Korea National Health and Nutrition Examination Survey (알레르기성 질환자의 우울증 유무에 따른 영양 상태 연구: 국민건강영양조사 데이터를 이용하여)

  • Oh, Soo-Yeun
    • Journal of the Korean Dietetic Association
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    • v.28 no.4
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    • pp.227-246
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    • 2022
  • This study was conducted on the nutritional status of 1,805 patients with allergic diseases (atopic dermatitis, allergic rhinitis, and asthma) aged 19 to 64 years according to their state of depression, based on the data from the Korea National Health and Nutrition Examination Survey (KNHANES). The Patient Health Questionnaire-9 (PHQ-9) was used to diagnose depression. Subjects with a score of 10 or more were categorized into the depression group (n=152) and the rest into the non-depression group (n=1,653). The results of this study were as follows: The proportion of women (75.7%) was higher than that of men (24.3%) in the depressed group (P<0.01). In terms of energy intake per 1,000 kcal, both men and women in the depressed group showed a lower energy intake than the non-depressed group and this intake was less than the estimated energy requirement (EER). The nutrient intakes of protein, calcium, phosphorus, iron, vitamin A, thiamine, riboflavin, niacin, folic acid, and vitamin C were below the estimated average requirement (EAR). Also, the intakes of fiber and potassium were less than the adequate intake (AI) (P<0.001). In the lifestyle parameters, the ratio of eating alone at lunch was 54.1%:33.1%, indicating that more than half of the depression group ate alone. In conclusion, it was observed that the nutritional status of allergic disease patients was imbalanced. The nutritional imbalance was due to insufficient energy intake and inadequate intake of nutrients, which was below the average requirements of vitamins and minerals and this was more evident in the depression group than in the non-depression group.

Bronchial Responsiveness in Patients with Mitral Valvular Heart Disease (승모판 심장질환 환자에서 기관지 반응성에 대한 연구)

  • Kim, Ho-Cheol;Kim, Min-Gu;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.752-759
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    • 1995
  • Background: Bronchial asthma is characterized by noctunal dyspnea, cough and wheezing because of airway hyperresponsiveness to nonspecific stimuli. These symptoms and signs are also observed in patients with congestive heart failure. Therefore, this is so called "cardiac asthma". There are lots of experimental and clinical datas to suggest that airway dysfunctions occur in acute and chronic congestive heart failure. However, it is still controversial whether bronchial hyperresponsiveness is present in patients with congestive heart failure. To assess whether bronchial hyperresponsiveness is present in patients with congestive heart failure and to demonstrate the relationship between bronchial responsiveness and vascular pressure, we performed methacholine provocation test in 11 patients with mitral valvular heart disease. Methods: All patients were in the New York Heart Association functional class II and treated continuously with digoxin and/or dichlozid and/or angiotensin converting enzyme inhibitor except one patient. All patients were undergone right and left side heart catheterization for hemodynamic measurements. A 20 percent fall of peak expiratory flow rate were considered as positive response to methacholine provocation test. Results: 1) Only one patient who has normal pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index was positive in methacholine provocation test. 2) Their mean pulmonary artery pressure, pulmonary capillary wedge pressure were $21.72{\pm}9.70mmHg$, $15.45{\pm}8.69mmHg$ respectively which were significantly higher. Conclusion: It is speculated that in stable congestive heart failure patients, bronchial responsiveness as assessed by methacholine provocation test may not be increased.

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Strategic Direction and Road Map of Expanding Prevention of Winter Disease in the Summer (동병하치 확산을 위한 전략적 방향과 이행방안)

  • Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.147-157
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    • 2010
  • Objectives : The purpose of this study was to propose appropriate strategic directions and road maps for successful achievement of programs preventing winter disease in the summer. Methods : Details on programs preventing winter disease in the summer such as clear concept, theoretical basis, current status, intervention or available prescriptions and indication/contraindication/caution were prepared through the related journal review, upon which an observational study was devised and done for simulation to find out even a trivial problem and to guarantee the safety beforehand. The experimental group was divided into 5 groups by the size of pill and the way ginger is treated; 1cm pill with ginger group, 3cm pill group without ginger, 3cm pill group dipped into ginger, 3cm pill group applying ginger to acupoints and 3cm pill group with ginger Results 1. program preventing winter disease in the summer was defined as representative winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis and rheumatoid arthritis, and preventive care in the summer, reinforcing deficient yang qi of five viscera by using exuberant yang qi from summer heat. 2. It was based upon historically established theories which is 'nourishing yang qi in the spring and summer', 'long summer, namely rainy spell in the summer overwhelms the winter, because of earth winning water according to the five phases theory' and 'To replenish yang qi is major principle to treat winter diseases, which can be most appropriately and timely applied to the patient with deficient yang qi of five viscera inherently, especially in the three dog days of the summer, because of exuberant exterior yang qi and deficient interior yang qi in the five viscera'. 3. In the adjacent China and Taiwan, acupoint applying method in the three dog days named 'San Fu Tie' have been stirring a boom throughout the nation, in which Xiaochuan Gao was used as a basic prescription and it mainly was applied at bilateral $BL_{13}$, $_{15}$ and $_{17}$ for about 4 hours. As far as domestic current status, the necessity of adopting the above method prior to Herbal formula was also recognised, because not a few koreans have apprehension for the safety of it including medicinal herbs and are reluctant to take it any more due to negative advertisement of narrow minded doctors' association. 4. Indication of acupoint applying method in the three dog days included most of winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis. contraindication was pregnant woman and the weak such as infants and the old. More attention was paid to grasp firmly the normal reaction following the treatment for preventing side effect and teasing blister. recommendation was also given to abstain from food inducing phlegm and dampness such as meat, shrimp and crab as well as cold drinks and foods 5. In the simulation observational study based upon the above findings following review the related articles, no blister was shown on the acupoints icluding bilateral $BL_{13}$, $_{15}$ and $_{17}$ in every experimental group during 24hr observation following the acupoint applying treatment with pills made by modified and devised prescription. At 4 hr, the effectiveness of it reached a peak showing redness and mild tenderness and there is little difference between groups 3cm pills groups regardless of the way ginger was treated. abdominal distention and growling was found in all the volunteers during the treatment at CV 8. Strategic directions and road maps : Through successful fulfillment of the program preventing winter disease in the summer, Korean traditional medicine should be integrated into mainstream national health care services. Cultural access was thought to be as important as Scientific EBM approach. First of all, To evoke potential cultural homogeneity from campaigns and press advertisement was needed for promoting public awareness about preventing winter disease in the summer by enhancing immunity via acupoint applying treatment in the three dog days, and then indigenous name as Sambokcheop, protocol, Clinical Research Form for data collection of it should be developed and prepared. Once the first step was taken this summer, through a thorough data collection and scrutinized scientific evaluation, drawbacks should be compensted for and the efficacy and safety should be substantiated.

Effect of Inhaled Fluticasone Propionate on Hypothalamic-Pituitary-Adrenal Axis in Bronchial Asthma Patient (기관지 천식환자에서 Fluticasone Propionate 흡입제가 Hypothalamic-Pituitary-Adrenal Axis에 미치는 영향)

  • Hwang, Jun-Kyu;Lee, Ho-Meong;No, Yang-Won;Park, Gye-Young;Park, Chong-Wung;Park, Jae-Kyung;Jeong, Seong-Hwan;Nam, Gui-Hyun;Kim, Hong-Kyu;Park, Hye-Young;Kang, Moon-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.25-34
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    • 2001
  • Background : Inhaled glucocorticoids are the medical treatment of choice in asthma patients. Fluticasone propionate is one of the most effective inhaled corticosteroids and has been reported to have minimal effect on the hypothalamic-pituitary-adrenal axis at the recommended dose. However, reports of long-term trials characterizing their systemic safety with chronic use are rare. This study was designed to evaluate the long-term safety of inhaled fluticasone propionate to the hypothalamic-pituitary-adrenal axis. Method : This study was conducted on 21 patients to evaluate the adrenal response to rapid ACTH stimulation test after 6 months of treatment with fluticasone propionate from $200\;{\mu}g$ to $750\;{\mu}g$ daily. The serum cortisol levels was measured to assess its effect on the hypothalamic-pituitary-adrenal axis just prior to the injection, at 30 minutes and 60 minutes after an intramuscular injection of synthetic ACTH. Result : The mean dose of inhaled fluticasone propionate was $355\;{\mu}g$ per day(SD=$174\;{\mu}g$, range=$200\;{\mu}g$ to $750\;{\mu}g$). The mean serum cortisol levels of the patients was $11.0\;{\mu}g/d{\ell}$(SD=$6.4\;{\mu}g/d{\ell}$) prior to the injection, $20.0\;{\mu}g/d{\ell}$ (SD=$7.7\;{\mu}g/d{\ell}$) after 30 minutes, and $23.0\;{\mu}g/d{\ell}$(SD=$6.3\;{\mu}g/d{\ell}$) after 60 minutes. Sixteen patients of the 21 patients had a normal response(> $18\;{\mu}g/d{\ell}$), and 5 out of the 21 patients had serum cortisol levels below the normal range after the rapid ACTH stimulation test. Conclusion: Adrenal suppression occurred in 5 out of 21 patients with 6 months treatment with inhaled fluticasone propionate.

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Clinical Observation of The Allergic Rhinitis (알레르기성 鼻炎 患者에 對한 臨床的 考察)

  • Kim, Nam-Kwen;Lim, Gyu-Sang;Hwang, Choong-Yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.10 no.1
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    • pp.367-382
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    • 1997
  • The author analyzed 46 cases of allergic rhinitis patients, who were treated in the Kwang-ju Oriental Medical Hospital of Wonkwang University from January 1997 to April 1996. I've examined the 46 cases in the view of age and sex distribution, seasonal distribution, distribution of the job, duration of the disease, past history, family history, distribution of complicated signs, the degree of recovery about the total patient, the relationship of the ages and the remedial value, the relationship of the duration of disease and the remedial value. The following results are obtained. 1. The ratio of under teenagers was $32.61\%$(15 cases), teenagers was $30.43\%$(11 cases), 2th decade was $17.39\%$(8 cases), 3th decade was $17.39\%$(8 cases), 4th decade was $4.35\%$(2 cases), 5th decade was $2.17\%$(1 case), over sixty was $2.17\%$(1 case). 2. The ratio of the male was $58.70\%$(27 cases) and femal was $41.30\%$(19 cases). 3. The ratio of spring was $21.74\%$(10 cases), summer was $8.70\%$(4 cases), fall was $43.48\%$(20 cases), winter was $43.48\%$(20 cases) and unknown was $10.87\%$(5 cases). 4. The ratio of the students was $45.65\%$(21 cases), house-wives was $15.22\%$(7 cases), office men was $10.87\%$(5 cases), farmers was $4.35\%$(2 cases), driver was $2.17\%$(1 case) and unemployed was $21.74\%$(10 cases). 5. The ratio of the under six months was $8.70\%$(4 cases), under 1 year was $17.39\%$(8 cases), under 3 years was $32.60\%$(15 cases), over 3 years was $41.31\%$(19 cases). 6. The ratio of atopic dermatitis was $32.61\%$(15 cases), allergic dermatitis was $21,74\%$(10 cases), the asthma was $17.39\%$(8 cases), digestion disorder was $6.52\%$(3 cases) and etc. 7. The ratio of paternal line was $21.74\%$(10 cases), maternal line was $13.04\%$(6 cases), paternal and maternal lines was $4.35\%$(2 cases), brother or sisters was $13.04\%$(6 cases) and non-significant was $47.83\%$(22 cases). 8. The ratio of sneezing was $100\%$(46 cases) , nasal discharge was $100\%$(46 cases), nasal obstruction was $86.96\%$(40 cases), pruritus was $45.65\%$(21 cases), headache was $13.04\%$(6 cases), asthma was $10.87\%$(5 cases), digestion disorder was $6.52\%$(3 cases), light phovia was $6.52\%$(3 cases), tears was $4.35\%$(2 cases), nosebreeding was $2.17\%$(1 case). 9. The total remedial value of the 46 patients was revealed $52.17\%$. 10. The remedial value of under teenagers, teenagers were higher than the total remedial value($52.17\%$). 11. The remedial value of under 6 months, under 1 year were higher than the total remedial value($52.17\%$). These results demonstrated that in the point of remedial view, the patients who were younger and shorter of the duration of disease, would be well recovered.

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Relationship Between Airway Inflammation Assessed by Induced Sputum and Airway Hyperresponsiveness in Asthmatic Patient (기관지천식 환자에서 유도객담으로 평가한 기도염증과 기관지 과민성과의 관계)

  • Chung, Lee-Young;Kim, Hyun-Jin;Jeong, Gyeong-Won;Kang, Mi-Jeong;Kim, Hwi-Jong;Chung, Hyo-Young;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.517-524
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    • 1999
  • Background : Airway inflammation and hyperresponsiveness are recognized as major characteristics of bronchial asthma. Airway inflammation has usually been assessed by invasive methods, e.g. BAL or bronchial biopsy, but recent studies proposed induced sputum as another reliable and non-invasive tool to investigate airway inflammation in asthmatic patients. Thus, the relationship between airway inflammation assessed by induced sputum and airway hyperresponsiveness was investigated in asthmatic patient. Method : Airway responsiveness was determined by the concentration that caused a 20% decrease in $FEV_1$($PC_{20}$) after inhaling incremental concentrations of methacholine. The numbers of inflammatory cells and the concentration of eosinophilic cationic protein(ECP) were assessed in induced sputum obtained by inhalation of hypertonic saline(3%). Result: We analyzed sputum induced in 15 stable asthmatic patients. The differential cell count(%) of macrophages, neutrophils, eosinophils and lymphocytes in induced sputum were $39.1{\pm}27.0%$, $29.6{\pm}21.0%$, $28.8{\pm}18.8%$, $1.3{\pm}3.1%$ respectively. The mean value of baseline FEV1(predicted) and ECP were $76.3{\pm}30.3%$ and $1,101{\pm}833{\mu}g/L$ respectively. The geometric mean value of $PC_{20}$ was 0.56 mg/mL. The relationships between the sputum eosinophil and ECP in induced sputum, and between sputum eosinophil and degree of airway responsiveness($PC_{20}$) were found to be significantly correlated (r=0.81, p<0.05 and r=-0.78, p<0.05, respectively). Sputum neutrophils and $PC_{20}$ were not correlated to each other (r=0.11, p=0.69) and a significant negative correlation was found between ECP and baseline $FEV_1$(predicted)(r=-0.62, p<0.05). Conclusion : The results of this study suggest that an induced sputum via a inhalation of hypertonic saline is useful to determine a patient's status of airway inflammation, and airway inflammation is one of the major causal factors in the development of bronchial hyperresponsiveness in asthmatic patients.

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Surgical Management of Idiopathic Tracheal Stenosis -Three case reports- (특발성 기관 협착증(Idiopathic Tracheal Stenosis)의 외과적 치험 -3예 보고-)

  • Kim, Hyung-Tae;Choi, Ho;Yoon, You-Sang
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.439-443
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    • 2003
  • A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.