• Title/Summary/Keyword: 기침

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The Bronchial Biopsies and Steroid Response in Unexplained Chronic Non-Productive Cough (원인을 알 수 없는 만성 기침의 기관지 생검소견과 경구 스테로이드의 효과)

  • Lee, Sang-Yeub;Jeong, Hye-Cheol;Kim, Kyung-Kyu;Kim, Je-Hyeong;Kwan, Young-Hwan;Lee, Sung-Yong;Lee, So-Ra;Cho, Hyun-Deuk;Lee, Sin-Hyung;Shim, Jae-Jeong;Cho, Jae-Yun;Kim, Han-Gyum;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.372-385
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    • 1999
  • Background: The purpose of this study was to examine the causes and pathologic process of chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph by investigating clinicopathologic findings. Method: We studied 25 adults with chronic non-productive cough over a 3-week period with a normal chest radiograph and pulmonary function tests without any other symptoms. Clinical assessment, cough score, chest and sinus radiograph, pulmonary function tests, methacholine challenge, allergic skin prick test, and bronchoscopy for bronchial biopsies were performed. Subjects were then treated with prednesolone 20 to 30 mg/day for 1 to 2 weeks. Results: The experimental group was divided into two subgroups-those infiltrated with eosinophils, and those infiltrated with lymphocytes depending on eosinophil and lymphocyte counts, both of which were respectively higher than those of the control group. Eosinophils infiltrated group had mean numbers of eosinophil of 89.8 $cells/mm^3$ while control group's mean was 0.4 $cells/mm^2$(p=0.005). Lymphocyte infiltrated group was 4 patients whose mean was 84.3 $cells/mm^2$ with 28.4 $cells/mm^2$ of control group(P=0.026). In addition, the mean thickness of the basement membrane of experimental group was $14.20{\pm}5.20{\mu}m$ in contrast of control group whose mean was $3.50{\pm}1.37{\mu}m$(P=0.001). With the methacholine challenge test, 7 of the 21 eosinophil infiltrated subjects were diagnosed with cough variant asthma ; the other 14 with eosinophilic bronchitis. Three subjects with eosinophilic bronchitis were atopic positive (21.4%) with the skin prick test In the lymphocyte dominant group, all four subjects were diagnosed with lymphocytic bronchitis. Cough score was improved after steroid treatment in 22 of 25 subjects in the experimental group (88.0%). Conclusion: These results suggest chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph was associated with airway inflammation by eosinophil and lymphocyte infiltration. The causes for chronic non-productive cough were eosinophilic bronchitis, cough variant asthma, and lymphocytic bronchitis(written in frequency). They further suggest that therapeutic treatment with steroids can provide effective symptomatic relief.

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건강 상담실

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.12 no.1 s.110
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    • pp.37-37
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    • 1988
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Foreign bodies in air passage in Children (소아의 기도이물에 관한 통계적 관찰)

  • 유장열;오경균;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.8.5-9
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    • 1977
  • Foreign bodies in food and air passage, especially the latter in infants and children requires emergency treatment. The frequent symptoms are coughing, wheezing, and dyspnea, So may be confused as asthma, pneumonia and acute Laryngitis. The species and incidence of the foregin bodies are variable according to the age, method of life, environment and economic condition. The authors experienced 35 cases of foreign body in air passage during the period of last 3yrs which were treated by ventilating Bronchoscopy, and thoractomy in this hospital. One of them was lead to death. The authors analysed above cases and report with it's literature consideration. Results: 1. The prevalent foreign bodies were peanut, metal, food particles in order of frequency. 2. In frequent symptoms were dyspnea, coughing and wheezing in the order. 3. In the age incidence, 48% of the foreign bodies were 1∼5yrs. 4. In sex distribution, male to female ratio was 2.1: 1 5. In duration of lodgment, 65% of the foreign body were removed within 24hrs. 6. Most prevalent site of the foreign body was Rt. main bronchus Rt. to Lt. ratis was 2 : 1 was 7. Treatment was done; 25 cases were by ventilating bronchoscopy.

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The Etiologic Diseases and Diagnostic Usefulness of Color Doppler Ultrasonography in Children with Chronic Coughs (소아 만성 기침의 원인 질환과 컬러 도플러 초음파 검사의 진단적 유용성)

  • Park, Sun Young;Lee, Joon Sung
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.489-497
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    • 2002
  • Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

Antihypertensive Effect and Safety of Imidapril on the Patient with Essential Hypertension (본태성 고혈압에 대한 Imidapril의 강압효과 및 마른기침 발현율에 대한 고찰)

  • Hong, Gue-Ru;Bae, Jun-Ho;Jun, Dae-Jin;Park, Jong-Seon;Sin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.69-75
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    • 1999
  • Imidapril(Tanatril$^{(R)}$), a newly developed ACE inhibitor, has been used to treat hypertension and congestive heart failure. This study was designed to assess the antihypertensive effect and safety of Imidapril(Tanatril$^{(R)}$) in patients with essential hypertension. 5-10mg of imidapril(Tanatril$^{(R)}$) was administered once a day in 30 patients with essential hypertension and followed up for 8 weeks. We tested the drug's effectiveness, safety, and the incidence of imidapril induced dry coughs. After 8 weeks of treatment with imidapril, 76.2%(16/21) of patients showed lowered blood pressure and 47.6% showed normal blood pressure. The overall incidence of adverse effects was 33.3%(7/21), and among these adverse effects, dry cough was shown in only 9.5%. Thus, we concluded that imidapril(Tanatril$^{(R)}$) is as safe and effective as other ACE inhibitors, especially with imidapril showing very little incidence of dry cough compared to other ACE inhibitors.

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Usefulness of Chest High-Resolution CT in Patients with Chronic Cough Below 2 Years of Age (2세 미만의 만성 기침 환아에서 흉부 고해상 전산화 단층 촬영의 유용성)

  • Kim, Myung Hyun;Kim, Jung Hee;Lim, Dae Hyun;Son, Byong Kwan;Lee, Kyung-Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.339-345
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    • 2002
  • Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.