• The Journal of Korean Medicine
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• v.24 no.3
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• pp.184-191
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• 2003

Background : Nowadays asthma is considered to be an inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Production of cytokines by bronchial epithelial cells may contribution to the local accumulation of inflammatory cells in patients with bronchial asthma. Chungsangboha-tang is the herbal treatment of choice in persistent asthma patients. It has been recognized that cessation of treatment with Chungsangboha-tang evokes a recurrence of symptoms in patients with controlled asthma. This study was designed to evaluate the long-term effect of Chungsangboha-tang. Materials and Methods : The subjects consisted of 24 patients with asthma who had been treated with Chungsangboha-tang for four weeks. Chungsangboha-tang is an herbal decoction which has been used as the traditional therapeutic agent for asthma. PFT, QLQAKA, blood eosinophils, serum IgE, Serum IL-4, IL-5, $IFN-{\gamma}$ were checked before treatment, before withdrawal and 3 months after cessation of treatment with Chungsangboha-tang. Results : Treatment with Chungsangboha-tang for four weeks resulted in significant increase in FEV1.0%, PEFR%, and QLQAKA. The patients were treated with Chungsangboha-tang for four weeks with no significant difference in the blood eosinophils, serum IgE, IL-4 and IL-5. The serum $IFN-{\gamma}$ in asthmatic patients decreased significantly after 4 weeks of treatment. Discontinuation of treatment with Chungsangboha-tang resulted in significant drops in QLQAKA. Others measures in asthmatic patients 3 months after discontinuation of treatment with Chungsangboha-tang showed no significant difference. Conclusion : This study demonstrates that asthma can be exacerbated by discontinuation of treatment with Chungsangboha-tang in patients with asthma. Obviously further research concerning this is still necessary.

• Tuberculosis and Respiratory Diseases
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• v.51 no.5
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• pp.474-481
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• 2001

Mesalazine(5-Aminosalicylic acid,5-ASA), a component of Sulfasalazine (sulfapyridine bound to 5-ASA), is used to treat inflammatory bowel disease. Most adverse pulmonary effects caused by sulfasalazine have been attributed to sulfapyridine. However, lung toxicity associated with mesalazine(5-ASA) is rare. Here we report a case of eosinophilic pneumonia in a 44-year-old woman with ulcerative colitis, who was treated with mesalazine. She developed symptoms of a dry cough, mild night fever, and exertional dyspnea. Bilateral peripheral pulmonary infiltrates, peripheral blood eosinophilia, and histologic features were consistent with eosinophilic pneumonia. The symptoms improved quite rapidly after the discontinuation of mesalazine and initiation of steroid therapy. Therefore, adverse pulmonary reactions to mesalazine must be considered in a differential diagnosis of pulmonary involvement in patients with inflammatory bowel disease who are receiving with mesalazine therapy.

• Tuberculosis and Respiratory Diseases
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• v.68 no.4
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• pp.226-230
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• 2010

Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/ day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.

• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.175-184
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• 2020

Quantitative sputum cytometry facilitates in assessing the nature of bronchitis associated with exacerbations of chronic obstructive pulmonary disease (COPD). This is not assessed in most clinical trials that evaluate the effectiveness of strategies to prevent or to treat exacerbations. While up to a quarter of exacerbations may be associated with raised eosinophil numbers, the vast majority of exacerbations are associated with neutrophilic bronchitis that may indicate airway infections. While eosinophilia may be a predictor of response to corticosteroids (oral and inhaled), the limited efficacy of anti-interleukin 5 therapies would suggest that eosinophils may not directly contribute to those exacerbations. However, they may contribute to airspace enlargement in patients with COPD through various mechanisms involving the interleukin 13 and matrix metalloprotease pathways. The absence of eosinophils may facilitate in limiting the unnecessary use of corticosteroids. The presence of neutrophiia could prompt an investigation for the specific pathogens in the airway. Additionally, sputum measurements may also provide insight into the mechanisms of susceptibility to airway infections. Iron within sputum macrophages, identified by hemosiderin staining (and by more direct quantification) may impair macrophage functions while the low levels of immunoglobulins in sputum may also contribute to airway infections. The assessment of sputum at the time of exacerbations thus would facilitate in customizing treatment and treat current exacerbations and reduce future risk of exacerbations.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.89-93
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• 2009

Purpose: Kimura's disease is an uncommon benign lymphoproliferative inflammatory disorder with an unknown etiology. The recurrence rate after surgical excision is relatively high and renal involvement is its only systemic manifestation. The condition mainly involves the head and neck, and peripheral involvement is extremely rare. Materials and Methods: We encountered the case of a 28-year-old man who had a non-tender mass with mild brownish skin color changes and pruritus around the medial side of the distal arm and elbow. Results: The peripheral blood investigation revealed peripheral eosinophilia and elevated serum IgE levels. Magnetic resonance imaging showed an isointensity signal relative to the muscle on the T1-weighted images and hyperintensity signal relative to the muscle on the T2-weighted images. Conclusion: A marginal resection of the lesion was performed and there was no recurrence at 2 years postoperatively.

• Journal of Veterinary Clinics
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• v.20 no.4
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• pp.496-500
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• 2003

A one-year-old male Japanese Chin with anorexia, retching, dyspnea and continuous coughing was brought to the Veterinary Teaching Hospital, Chungbuk National University. Chest radiographs showed moderate regional alveolar pattern with mild interstitial patterns in the caudo-dorsal lung fields and the ill-defined mass in the perihilar area which is consistent with perihilar lymphadenopathy. Although the dog showed severe eosinophilia in the complete blood count, the serum profile values were within normal ranges. There was no indication of any parasite infestation in the direct and floatation examination of feces, skin scraping test and heartworm examination. There was no growth of bacteria and fungi in the selected media such as Mueller Hinton broth, Sabouraud Dextrose agar and Potato Dextorse agar, which were inoculated with tracheal fluid collected using endotracheal tube and cultured for 3 days. In the tracheal fluid smear, most prominent cells were eosinophils, which are a almost 80% of total cells and other cells such as leukocytes, neutrophils and ciliated colummar cells were also observed. Any parasite was also not detected in its smear. Prednisolone (PDS; 1 mg/kg, BID SC), aminophylline (10 mg/kg, TID IV) and nebulization with gentamicin (50 mg) plus saline (3 ml) were given for 1 week. At 3rd day of treatment, blood eosinophil value was return to normal range and pulmonary condition was also improved. The allergen test with serum performed during therapy was positive in the 19 index including milk, barley, tomato pomace, catfish, bonito, house dust and wool, and borderline in 10 index including wheat, house dust mites and house fly. The patient is responding well to PDS therapy. Based on these findings, a possible diagnosis of pulmonary infiltration with eosinophils was made in this dog.

• Journal of Korean Medicine for Obesity Research
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• v.17 no.2
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• pp.77-86
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• 2017

Objectives: This study examined the effects of salvianolic acid B (SAB) on exhaustive exercise-induced cardiac muscle damage to rats. Methods: The study was carried out with 12-week-old young adult male Sprague-Dawley rats. Thirty-six rats were divided into 3 groups; normal (n=12), exhaustive exercise group (ExS, n=12) and exhaustive exercise with SAB (ExS+SAB, n=12). Five days before exhaustive exercise, SAB were medicated for 5 days in ExS+SAB group. Rats in ExS and ExS+SAB group were forced to swim for 150 minutes and then they were sacrificed, while rats in normal group were sacrificed at rest. After that, blood was collected and cardiac muscle tissue damage indices were analyzed. Results: Serum aspartate transaminase activity and lactate dehydrogenase activity were significantly lower in ExS+SAB group than in ExS group. Serum creatine phosphokinase activity of ExS+SAB was significantly lower than ExS group. However, the content of serum creatinine had no difference between ExS and ExS+SAB group. In the H&E stained left ventricle myocardium, ExS group showed signs of myocardial damage such as sporadic fragmentation of myocardial fibers, interstitial edema, cytoplasmic eosinophilia and neutrophils infiltration. However, ExS+SAB group alleviated the severity of the signs of myocardial damage. In the myocardial dihydroethidium staining, optical density was remarkably decreased in ExS+SAB group compared to ExS group. Furthermore, the up-regulation of Bax/Bcl-2 ratio was observed in ExS+SAB group compared with ExS group. Conclusions: The above results suggest that SAB may protect cardiac muscle damage via antioxidant activity and prevention of apoptosis.

• Clinical and Experimental Pediatrics
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• v.64 no.8
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• pp.373-383
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• 2021

Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%-89% of the chronic rhinitis cases, affecting 1%-50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally rather mild and less likely to be associated with allergic comorbidities than allergic rhinitis. Here, we aimed to estimate the rate of coexisting comorbidities of nonallergic rhinitis. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Local allergic rhinitis is a recently noted phenotype with rates similar to those in adults (median, 44%; range, 4%-67%), among patients previously diagnosed with nonallergic rhinitis. Idiopathic rhinitis, a subtype of nonallergic rhinitis, has been poorly studied in children, and its rates are known to be lower than those in adults. The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. Conventional treatments include antihistamines, intranasal corticosteroids, and recent treatments include combination of intranasal corticosteroids with azelastin or decongestants. Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.

• Translational and Clinical Pharmacology
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• v.25 no.2
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• pp.63-66
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• 2017

Allopurinol-induced severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome are reportedly associated with the $HLA-B^{\star}58:01$ genotype. Three patients who developed SCARs after allopurinol administration were subjected to HLA-B genotyping and lymphocyte activation test (LAT) to evaluate genetic risk and to detect the causative agent, respectively. All three patients given allopurinol to treat gout were diagnosed with DRESS syndrome. Symptom onset commenced 7-24 days after drug exposure; the patients took allopurinol (100-200 mg/d) for 2-30 days. HLA-B genotyping was performed using a polymerase chain reaction (PCR)-sequence-based typing (SBT) method. All patients had a single $HLA-B^{\star}58:01$ allele: $HLA-B^{\star}13:02/^{\star}58:01$ (a 63-year-old male), $HLA-B^{\star}48:01/^{\star}58:01$ (a 71-year-old female), and $HLA-B^{\star}44:03/^{\star}58:01$ (a 22-year-old male). Only the last patient yielded a positive LAT result, confirming that allopurinol was the causative agent. These findings suggest that patients with $HLA-B^{\star}58:01$ may develop SCARs upon allopurinol administration. Therefore, HLA-B genotyping could be helpful in preventing serious problems attributable to allopurinol treatment, although PCR-SBT HLA-B genotyping is time consuming. A simple genotyping test is required in practice. LAT may help to identify a causative agent.

• Investigative Magnetic Resonance Imaging
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• v.25 no.4
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• pp.332-337
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• 2021

Behçet's disease is a chronic inflammatory disorder involving vessels of various sizes and organs, including the skin, joints, gastrointestinal tract, lungs, and cardiovascular system. The etiology of Behçet's disease is unclear, and clinical diagnosis is important in the absence of definitive laboratory or pathological findings diagnostic of Behçet's disease. Cardiac involvement is rare but might present as endocarditis, myocarditis, pericarditis, or intracardiac thrombosis. This report presents a case of Behçet's disease involving the heart in a 22-year-old man with unusual manifestations of right ventricular fibrosis and intracardiac thrombosis. Cardiac magnetic resonance imaging revealed multiple intracardiac thrombi and delayed diffuse subendocardial enhancement involving the right ventricle. No peripheral eosinophilia was detected. Endomyocardial biopsy showed mixed inflammatory cell infiltrates. Based on the patient's clinical history of oral ulcer and arthritis, a diagnosis of Behçet's disease was made considering the clinical, radiological, and histological findings. Intracardiac thrombi and endomyocardial fibrosis are rare manifestations of Behçet's disease, and the diagnosis is often a clinical challenge. Early diagnosis is important for appropriate management. Behçet's disease should be considered in the differential diagnosis of patients with intracardiac thrombosis and endomyocardial fibrosis of the right chamber.