• Journal of Medicine and Life Science
• /
• v.16 no.2
• /
• pp.43-45
• /
• 2019

Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.

• Korean Journal of Exercise Nutrition
• /
• v.13 no.1
• /
• pp.59-67
• /
• 2009

Houttuynia Cordata Thunb, well known as "E-Sung Cho" in Korea, has been used for the treatment of herpes simplex, chronic sinusitis and nasal polyps. Recently, some studies reported the antileukemic activity, anticancer activity, adjuvanticity, and antioxidant action of Houttuynia Cordata Thunb. In the present study, the anti-obesity activity of Houttuynia Cordata Thunb was investigated. Middle-aged women were examined over a period of 8 weeks (n=30). Participants were divided into four group: Houttuynia Cordata Thunb Exercise (HCE, n=7), Placebo Exercise (PE, n=8), Houttuynia Cordata Thunb Non Exercise (HCNE, n=8), and Placebo Non Exercise (PNE, n=7). Participants in Houttuynia Cordata Thunb groups were received 4.5 g Houttuynia Cordata Thunb and in placebo groups were received same dose of placebo thrice daily with meals. The result after 8 weeks demonstrated that HCE significant decreased visceral fat than PNE. Our present study provides the evidence that Houttuynia Cordata Thunb intake and exercise performance may reduce visceral fat and further studies with larger numbers of subjects are warranted to conclusively demonstrate effectiveness.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.1
• /
• pp.146-153
• /
• 1997

Background : Chronic cough is commomly defined as a persistent or recurrent cough exceeding 3 week's duration. The prevalence of chroinc cough is reported to range from 14% to 23 % for nonsmoking adults. The post nasal drip syndrome has been determined to be the most common cause of chronic cough, followed by asthma, chronic bronchitis, gastroesophageal reflux and bronchiectasis. Cough can be the only manifestation of asthma. Bronchial provocation tests are useful in diagnosing cough variant asthma. We investigated the clinical or laboratory findings and the incidence of airway hyperresponsiveness and evaluated the etiology in patients with chronic cough. Method : We evaluated 46 patients with chronic cough. Methacholine challenge test were done. Results : The results were as follows : 1) Thirty - five percent(16/46) of the chronic cough patients and 44% of the post nasal drip syndrom(7/16) showed the positive responses to methacholine challenge test 2) The underlying causes of chronic cough were post nasal drip syndrome in 35%, bronchitis in 21.7%, cough-variant asthma in 17.4%, and unknown condition in 25.9%. 3) Airway hyperresponsiveness in chronic cough was not related to respiratory symptom, nasal symptom, post nasal drip, smoking, derangement of ventilatory function, atopy, or sinusitis. Conclusion : Airway hyperresponsivenss in patients with chronic cough increased in frequency when compaired with normal control, allergic rhinitis. Cough-variant asthma account for 17.4% of patients with chronic cough.

• Tuberculosis and Respiratory Diseases
• /
• v.77 no.3
• /
• pp.136-140
• /
• 2014

Primary ciliary dyskinesia (PCD) is characterized by the congenital impairment of mucociliary clearance. When accompanied by situs inversus, chronic sinusitis and bronchiectasis, PCD is known as Kartagener syndrome. The main consequence of impaired ciliary function is a reduced mucus clearance from the lungs, and susceptibility to chronic respiratory infections due to opportunistic pathogens, including nontuberculous mycobacteria (NTM). There has been no report of NTM lung disease combined with Kartagener syndrome in Korea. Here, we report an adult patient with Kartagener syndrome complicated with Mycobacterium abscessus lung disease. A 37-year-old female presented to our hospital with chronic cough and sputum. She was ultimately diagnosed with M. abscessus lung disease and Kartagener syndrome. M. abscessus was repeatedly isolated from sputum specimens collected from the patient, despite prolonged antibiotic treatment. The patient's condition improved and negative sputum culture conversion was achieved after sequential bilateral pulmonary resection.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.2
• /
• pp.221-227
• /
• 2006

Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

• Tuberculosis and Respiratory Diseases
• /
• v.57 no.6
• /
• pp.535-542
• /
• 2004

Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

• Sleep Medicine and Psychophysiology
• /
• v.15 no.2
• /
• pp.94-99
• /
• 2008

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.4
• /
• pp.338-347
• /
• 2001

Purpose: This is to review the cases of posterior maxillary segmental osteotomies to regain the interarch spaces for dental implants in the posterior mandible. Materials & Methods: Seven patients who presented with alveolar extrusion of upper posterior molars underwent segmental osteotomies by single-stage Kufner's buccal approach under the intravenous sedation and local anesthesia. The posterior maxillary cento-alveolar segments were repositioned upward using pre-fabricated palato-occlusal resin splints and immobilized with osteosynthesis microplates and screws. Dental implants were installated simultaneously. The regained spaces, tooth vitality, periodontal healing, relapse, tenderness on function, and complications including maxillary sinus involvements were evaluated periodically for over one year after the surgeries. Results: The single-tage procedures were completed within 80 minutes without any surgical complications. The posterior maxillary segments were repositioned upward to regain the interarch spaces ranging from 2.5 to 5.5mm. All teeth involved in the procedures keep their vitalities. The repositioned segments were maintained showing neither evidence of periodontal break-down nor tenderness to function. One patient whose segments had not been immobilized by osteosynthesis plate resulted in 2mm down-ward relapse in post-operative 8 months. A case of postoperative nasal bleeding from the posterior-lateral wall resulted in oroantral fistula and chronic maxillary sinusitis later. Conclusion: The extruded dento-alveolar segments of the posterior maxilla were repositioned properly by Kufner's one-stage segmental osteotomies. One microplate can be of help to keep the position until the osseous healing enough to support the masticatory force.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.4
• /
• pp.457-462
• /
• 2002

Karagener's syndrome is an inherited condition characterized by triad of chronic paranasal sinusitis, situs inversus, and bronchiectasis, Since 1976, Afzelius found a lack of dynein arm in immotile spermatozoa by electron microscopy, numerous recent studies have focused on the ultrastructural defect in the cilia and reported that the variety type of ultrastructural defect in immotile cilia syndrome. We report a female patient who had the Katagener's triad with rare multiple ultrastructural defect of cilia in one patient. The electron microscopic examination showed partial dynein arm defect, loss of radial spoke, microtubular transposition, and giant cilia.

• The Journal of Pediatrics of Korean Medicine
• /
• v.13 no.2
• /
• pp.149-170
• /
• 1999

The author measured IL-2, IL-4, IL-6, TNF-${\alpha}$ and total protein(TP) level of middle ear effusion(MEE) of 24 ears - 13 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang - of pediatric recurrent otitis media with effusion(PROME) using ELISA assay, and compared the level of cytokines(pg/ml)/TP(mg/dl). And investigated the clinical finding in those children. The results were obtained as follows: 1. The level of IL-2／TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.05). 2. The level of IL-4/TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.0l). 3. The level of IL-6/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.05). 4. The level of TNF-${\alpha}$/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.01) 5. 79.1% of children with recurrent otitis media with effusion(ROME) were also complicated to chronic sinusitis. The children's t-test was used to make a statistical comparison between the groups. According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by control produce of cytokines which are connected with inflammatory reaction.