Corticosteroids are widely used in the treatment of various diseases because of its potent antiinflammatory effect. According to recent knowledge, bronchial asthma is also chronic inflammatory disease. Therefore antiinflammtory agent such as cromoyln sodium and corticosteroid is highly recommended for treament of chronic bronchial asthma. Especially hydrocortisone succinate (Solu-Cortef) is commonly used for treament to acute asthmatic attack via intravenous injection due to have rapid therapeutic onset and short duration. Since Sunaga et al. reported acute asthma attack after hydrocortisone injection in 1973, several cases of bronchospam with or without angioedema and urticaria after intravenous injection of hydrocortisone have been reported. We experienced a case of severe bronchospasm and acute respiratory failure after intraveous injection of hydrocortisone succinate in 64 year-old female asthmatic patient who visited to emergency room for acute asthmatic attack. About 5 minites after Solu-Cortef injection, a severe bronchospasm with arterial hypoxemia was developed. In order to confirm the suspected relationship between the offending drug(Solu-Cortef) and acute bronchospasm, we examed intravenous and inhalation provocation test by hydrocortisone succinate and methylprednisolone(control). After administration of hydrocortisone succinate via intravenous and inhalation route, severe asthmatic attack occurred. But administration of intravenous methylprednisolone and orall triamcinolone and saline were not provoke bronchospasm. Skin test using hydrocortisone sodium succinate was also positive. Administration of hydrocortisone is very serious to asthmatic patient with hydrocortisone hypersensitivity. Therefore, the clinician must be have history taking about previous adverse reaction of steroid before its clinical use. And methylprednisone may be useful and safe drug to the treatment of acute asthmatic patient with hydrocortisone hypersensitivity.
Kim, Seung Soo;Choi, Eu Gene;Park, Seoung Ju;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun
Tuberculosis and Respiratory Diseases
/
v.58
no.1
/
pp.25-30
/
2005
Background : An insertion-deletion polymorphism of angiotensin converting enzyme (ACE) gene has been shown to be associated with enzyme activity levels of ACE. Reported results that have been mutually contradictory about asthmatic hypersensitiveness and occurrence according to ACE gene insertion (I)/deletion (D) polymorphism. Also, the involvement of the ACE genes as the genetic basis of bronchial asthma is currently controversy. We investigated whether there was any association between polymorphisms of the ACE genes and airway hyper-responsiveness in chronic obstructive pulmonary disease (COPD). Methods : A total of 100 patients with COPD were enrolled in this study. The ACE genotypes were determined in all subjects by polymerase chain reaction. Pulmonary function test including bronchodilator response (BDR), methacholine bronchial provocation test (MBPT) were done in those patients. Airway hyper-responsiveness include any findings of positive BDR or MBPT. Results : In COPD patients, the ACE genotype distribution did not differ significantly among groups of patients with severities of COPD, and with or without airway hyper-responsiveness. Conclusions : These results suggest that polymorphisms of the ACE gene may not be associated with airway hyper-responsiveness, development and severity of COPD.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.26
no.4
/
pp.60-69
/
2013
Objective : This case series study was designed to assess the effect of Gamisungmagalguntang for chronic urticaria identified as "Wind-Heat" pattern by retrospective methods. Methods : We treated 19 patients for chronic urticaria with Gamisungmagalguntang(加味升麻葛根湯), who visited to care chronic urticaria at the department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine at Kyunghee University Korean Medical Center from 1st January 2013 to 31st August 2013. We analyzed information and body conditions of 19 patients. And by using Urticaria Activicy Score(UAS), frequency and number of wheals, itch severity and total score on a 4-point(0-3) scale were assessed in 19 patients. The change of each criterion and total scores between baseline and follow up were analyzed using paired t-test and Wilcoxon test(p<0.05). Results : 1. UAS improvement was statistically significant(p<0.001). Effects of symptom improvement were excellent(31.58%) that means symptom remission and good(42.10%) that means symptom improved over 50%. 2. Heat sensitivity as suspected provocation factor could be a marker for the Wind-Heat pattern urticaria. 3. Among the Wind-Heat pattern urticaria patients, normal digestion(52.63%) and no thirst(78.95%) were higher than abnormal conditions. Whereas about sweat item, abnormal conditions(57.89%) were higher than normal. That means abnormal sweat conditions could be a marker for a defense qi(衛氣) dysfunction of the Wind-Heat pattern urticaria. Conclusions : Our findings suggest that Gamisungmagalguntang could be effective on the Wind-Heat pattern urticaria.
Park, So-Yong;Park, Jong-Won;Oh, Yeon-Mok;Rhee, Yang-Keun;Lee, Young-Mok;Park, Yong-Bum;Lim, Seong-Yong
Tuberculosis and Respiratory Diseases
/
v.71
no.1
/
pp.24-29
/
2011
Background: The rising prevalence of asthma worldwide may be associated with the rising prevalence of obesity in developed nations. Although several studies have suggested a relationship between asthma and obesity, controversy still remains. The aim of this study was to examine the relationship between obesity and asthmatic factors such as atopy, eosinophilia, serum total Ig E and bronchial hyperresponsiveness in chronic cough patients. Methods: This study was a retrospective, observational study in two centers done between January 2007 and June 2008. The subjects included individuals who had a chronic cough. We examined body mass index (BMI) to measure obesity and pulmonary function. We did a metacholine provocation test for airway hyperresponsiveness (AHR), a skin prick test for atopy, and tests for blood eosinophils and serum IgE. Results: A total of 1022 subjects were included. Airway hyperresponsiveness was not related with obesity (p=0.06), and atopy incidence was significant higher in non obese patients (p=0.00). There was no significant difference in serum IgE and blood eosinophil counts between obese and non obese patients. Forced expiratory volue in one second ($FEV_1$)/forced vital capacity (FVC) was significantly reduced in obese patients (p=0.03), but FEV1 and FVC were no significant difference between obese and non obese patients. Conclusion: There is no relationship between obesity and bronchial hyperresponsiveness. The nonobese group appears to have more atopy. The relationship between obesity and bronchial hyperresponsiveness and atopy need further investigation.
Background: Persistent cough has recently been found to be associated with Chlamydia pneumoniae infection. We aimed to investigate the infection rate of C. pneumonia in adult patients with chronic cough. Methods: We recruited 68 patients with persistent cough lasting in excess of 3 weeks, who visited Kangdong Sacred Heart Hospital from January 2005 to August 2005. On the first visit, chest and paranasal sinuses radiography, skin prick test of common allergens, and induced sputum samples for C. pneumoniae were performed in all of patients. Further evaluation for diagnosis included a methacholine provocation test and eosinophil counts in induced sputum. Results: The most common cause of chronic cough was upper airway cough syndrome (UACS) (26.5%), followed by eosinophilic bronchitis (20.6%) and cough variant asthma (16.2%). Idiopathic chronic cough was the cause in 33.8% of patients. The mean duration of cough was 11.7 months. C. pneumoniae was isolated by polymerase chain reaction (PCR) from one patient who had upper respiratory air way syndrome. Conclusion: Chlamydia pneumoniae appears to have a minor role as a cause of chronic cough in patients.
Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
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.
Background: It is challenging to diagnose asthma in preschool children. The asthma predictive index (API) has been used to predict asthma and decide whether to initiate treatment in preschool children. Purpose: This study aimed to investigate the association between questionnaire-based current asthma with API, pulmonary function, airway hyperreactivity (AHR), fractional expiratory nitric oxide (FeNO), and atopic sensitization in preschool children. Methods: We performed a population-based cross-sectional study in 916 preschool children aged 4-6 years. We defined current asthma as the presence of both physician-diagnosed asthma and at least one wheezing episode within the previous 12 months using a modified International Study of Asthma and Allergies in Childhood questionnaire. Clinical and laboratory parameters were compared between groups according to the presence of current asthma. Results: The prevalence of current asthma was 3.9% in the study population. Children with current asthma showed a higher rate of positive bronchodilator response and loose and stringent API scores than children without current asthma. The stringent API was associated with current asthma with 72.2% sensitivity and 82.0% specificity. The diagnostic accuracy of the stringent API for current asthma was 0.771. However, no intergroup differences in spirometry results, methacholine provocation test results, FeNO level, or atopic sensitization rate were observed. Conclusion: The questionnaire-based diagnosis of current asthma is associated with API, but not with spirometry, AHR, FeNO, or atopic sensitization in preschool children.
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.16
no.4
/
pp.398-412
/
2006
The purpose of this study is to investigate the relationship between the acceleration of vibration by the powered hand tools used in the shipbuilding industry, and to develop the prospective prevalence model for the hand-arm vibration syndrome among the shipbuilding workers.The acceleration levels and frequencies of six types of grinder were measured using the ISO5349 method along with the time of exposure to the vibration from the powered hand tools. Medical examination for 114 workers were performed using the cold provocation test. Comparisons were made between the estimated prevalence of hand-arm vibration syndrome from ISO5349 and the observed values from the medical examinations. By multiple regression, we developed the prospective prevalence model of hand-arm vibration syndrome produced by the hand tools used in the shipbuilding industry. 4 hour-energy-equivalent frequency-weighted accelerations were $6.23m/s^2$ in the grinding job done after welding, and $13.39m/s^2$ in the grinding job done before painting. The mean exposure time while holding powered hand tools was 4.64 hours. Prevalence rates of Raynaud's Phenomenon were 12.04% in the grinding after soldering, and 42.9% in the grinding before painting measured using the ISO5349 method. After exposure to vibration for 10.79 years, about a half of the workers in the grinding after welding could developed Raynaud's Phenomenon. For the workers in the grinding before painting, the latency was 5.02 years. The ISO equation for dose response relationship was not significantly correlated with observed recovery rates of finger skin temperatures, blood flows and amplitudes of nerve conduction velocities. A multiple regression model for dose-response relationship was proposed from the results. Recovery rate of the skin temperatures = -0.668+ 0.337 ${\times}$ 4 hour energy equivalent frequency-weighted accelerations + 0.767 ${\times}$ duration of vibration exposure(years) The validity was proved by multiple regression analysis after correlation transformation and regression results based on model-building data and validation data.
Kim, Hae Jin;Kim, Yeryung;Park, Su Jung;Bae, Boram;Kang, Hye-Ryun;Cho, Sang-Heon;Yoo, Hae Young;Nam, Joo Hyun;Kim, Woo Kyung;Kim, Sung Joon
The Korean Journal of Physiology and Pharmacology
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v.19
no.1
/
pp.65-71
/
2015
Asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness (AHR) and reversible airway obstruction. Methacholine (MCh) is widely used in broncho-provocation test to evaluate airway resistance. For experimental investigation, ovalbumin-induced sensitization is frequently used in rodents (Ova-asthma). However, albeit the inflammatory histology and AHR in vivo, it remains unclear whether the MCh sensitivity of airway smooth muscle isolated from Ova-asthma is persistently changed. In this study, the contractions of airways in precision-cut lung slices (PCLS) from control, Ova-asthma, and IL-13 overexpressed transgenic mice (IL-13TG) were compared by analyzing the airway lumen space (AW). The airway resistance in vivo was measured using plethysmograph. AHR and increased inflammatory cells in BAL fluid were confirmed in Ova-asthma and IL-13TG mice. In the PCLS from all three groups, MCh concentration-dependent narrowing of airway lumen (${\Delta}AW$) was observed. In contrast to the AHR in vivo, the $EC_{50}$ of MCh for ${\Delta}AW$ from Ova-asthma and IL-13TG were not different from control, indicating unchanged sensitivity to MCh. Although the AW recovery upon MCh-washout showed sluggish tendency in Ova-asthma, the change was also statistically insignificant. Membrane depolarization-induced ${\Delta}AW$ by 60 mM $K^+$ (60K-contraction) was larger in IL-13TG than control, whereas 60K-contraction of Ova-asthma was unaffected. Furthermore, serotonin-induced ${\Delta}AW$ of Ova-asthma was smaller than control and IL-13TG. Taken together, the AHR in Ova-asthma and IL-13TG are not reflected in the contractility of isolated airways from PCLS. The AHR of the model animals seems to require intrinsic agonists or inflammatory microenvironment that is washable during tissue preparation.
The Journal of the Convergence on Culture Technology
/
v.9
no.2
/
pp.227-233
/
2023
Along with the 4th Industrial Revolution, the impact of "unmanned" is affecting all fields around the world, and in particular, in the military sector, "unmanned" is so important that it occupies a part of the main combat system. Recently, the South Korean military is facing a crisis due to the North Korea's UAV incident that invaded our airspace and descended to Seoul. In response, the South Korea military declared its willingness and countermeasures to capture and destroy North Korea's UAV. However, as the technological development of UAV continues and the utilization plan is expanding, the countermeasures for UAV at the current level can be useless. Also, the threat from North Korea is not just UAV. North Korea has practically a nuclear power and is set to conduct its seventh nuclear test, and its missile technology is also being advanced, with 38 arounds of 67 missile tests conducted in 2022 alone. It is also developing five key strategic weapons that can pose a fatal threat to Korea, and North Korea's strong conventional forces are located around the NLL(Northern Limit Line), and the port of Long Range Artillery is facing the Seoul metropolitan area. It is important to respond to North Korea's UAV threats, which are now receiving much attention, but it will be necessary to comprehensively analyze and clearly prioritize North Korea's threats and use a limited budget to respond to them.
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