• Tuberculosis and Respiratory Diseases
• /
• v.40 no.4
• /
• pp.390-394
• /
• 1993

Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.3
• /
• pp.388-402
• /
• 1996

Background : To compare the diagnostic accuracies of High-resolution CT(HRCI) and chest radiography in the diagnosis of diffuse infiltrative lung disease(DILD). Methods : This study included ninety-nine patients with a diagnosis of acute or chronic DILD, representing 20 different diseases. Twelve normal subjects were included as control. The disease state was confirmed either pathologically or clinically. Radiographs and CT scans were evaluated separately by three independent observers without knowledge of clinical and pathologic results. The observers listed three most likely diagnoses and recorded degree of confidence. Results : The sensitivity of HRCT in the detection of DILD was 98.9% compared to 97.9% of chest radiography. Overall, a correct first-choice diagnosis was made in 48% using chest radiographs and in 60% using HRCT images. The correct diagnosis was among the top-three choices in 64% when chest radiographs were used, and in 75% when HRCT images were reviewed. Overally a confident diagnosis was reached more often with HRCT(55%) than with chest radiography(26%). The correct first-choice diagnosis increased remarkably when the HRCT was used in usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis and lymphangitic carcinomatosis. Conclusion : HRCT is confirmed to be superior to conventional radiography in the detection and accurate diagnosis of DILD. HRCT is especially valuable in the diagnosis of usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis, and lymphangitic carcinomatosis.

• KSBB Journal
• /
• v.24 no.4
• /
• pp.383-392
• /
• 2009

Xanthii fructus which is well known as "Chang-ihjah" in Korea is the dried fruit of Xanthium strumarium L. (or Xanthium sibiricum PATR. Ex WIDD., Asteraceae. XS). Water extract of this fruit has been used for treatment of various inflammatory diseases such as tympanitis, allergic rhinitis, or ozena as alternative therapy material usually by oral administration in far Eastern countries including Korea. In this study, the effect of XS extract (XS-E) or XS-30% acetone fraction layer (XS-30% AFL) on the differentiation of $CD4^+$ T cells isolated from NC/Nga mouse and the production of IL-17 was investigated. The experimental results showed that $100\;{\mu}g$/mL of XS-E could decrease the production of IL-17 by $CD4^+$ Th17 cells by 2 fold and only $20\;{\mu}g$/mL of XS-30% AFL could inhibit 3.5 fold. The amount of IL-17A and IL-22 mRNA determined by real-time PCR was decreased remarkably when XS-E or XS-30% AFL was treated on $CD4^+$ Th17 cells(p<0.01, p<0.001). The amount of IL-17A protein determined by ELISA was also decreased remarkably(p<0.05, p<0.001). To study the effect of XS-E or XS-30% AFL on the proliferation of Th17 cells, $CD4^+$ T cells of a NC/Nga mouse was firstly differentiated by rIL-6/TGF-$\beta$ and then stimulated by rIL-23. The control group of Th17 cells were doubled every each day, while those of XS-E or XS-30% AFL treated group were shown to be delayed remarkably by these extracts. In conclusion, XS can inhibit the differentiation of Th17 cells of NC/Nga mouse and the production of IL-17 successfully, which may be a beneficial result for the treatment of atopic skin dermatitis.

• Journal of Oral Medicine and Pain
• /
• v.36 no.3
• /
• pp.169-176
• /
• 2011

Oromandibular dystonia (OMD) is a form of focal dystonia that affects the masticatory, facial and lingual muscles in any variety of combinations, which results in repetitive involuntary and possibly painful jaw opening, closing, deviation or a combination of these movements. This study aimed to investigate clinical features and treatment type of OMD patients. By retrospective chart review, the study was conducted to consecutive OMD patients who visited a department of Oral Medicine and Orofacial Pain Clinic in a university dental hospital during Aug 2007 to Apr 2010. 78 OMD patients were identified with female preponderance (M:F=1:3.6) and a mean age of 72 years. Their mean duration of OMD was about 10 months. The most common chief complaints at the first visit was jaw ache, followed by uncontrolled, repetitive movement of the jaw and/or oral tissues, pain in the oral region(p=0.000). The most common subtype of OMD was lateral jaw-deviation dystonia, followed by combination and jaw-closing dystonia(p=0.001). While no apparent cause was recognized in over 60% of the OMD patients, peripheral trauma including dental treatment such as prosthetic treatment and extraction was the most frequently reported as precipitating factor(p=0.000). Medication was the 1st line therapy for our patients and anxiolytics such as clonazepam was given to most of them. Based on the results of this study, OMD is the disease of the elderly, particularly of women and causes orofacial pain and compromises function of orofacial region. Some patients considered dental treatment a precipitating factor. Dentists, therefore, should have knowledge of symptoms and treatment of OMD.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.11 no.2
• /
• pp.40-48
• /
• 2005

In this study, the muscle strength and endurance of the lumbar at flexion and extension were determined using an isokinetic muscle strength meter (Biodex) in patients with chronic lumbar go (10 male and 10 females), and the changes in muscle strength and endurance of the lumbar at flexion and extension after application of Y-shaped sacrospinalis muscle taping, typically used for patient with lumbar go, were studied. In addition, the sacrospinalis muscle taping of a different shape (I-shaped taping) was applied bilaterally centering on the spine, and the muscle strength and endurance of the lumbar at flexion and extension were determined and compared with those before taping. In addition, the results after application of Y-shaped taping and I-shaped taping were also compared. 1. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio taping and after application of Y-shaped taping did not show the level of significance. 2. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and application of Y-shaped taping did not show the level of significance. The extensor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping did not show the level of significance. 3. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 4. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio taping and after application of I-shaped taping showed the level of significance. The extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 5. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $60^{\circ}$/ sec showed the level of significance (p<.05). 6. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not showed the level of significance (p<.05).

• Journal of agricultural medicine and community health
• /
• v.29 no.2
• /
• pp.265-285
• /
• 2004

Objectives: The acute toxic effects of pesticide are well known. Concern has also been expressed that long-term exposure may result in damage to the central nervous system. This study was conducted to test the hypothesis that central nervous system symptoms might occur due to pesticide exposure. Methods: In a cross-sectional study, first, cumulative exposure index (CEI) was estimated. Neurologic symptoms (Q-16 questionnaire) for 541 farmers (exposed to pesticides) were compared with 119 non-exposed persons in spraying season nine rural areas in Korea. Results: The pesticides poisoning rates for last 3 months were 67.2% for orchard farmers, 55.3%for dry field farmers, and 20.5% for husbandry farmers, respectively, showing significant difference (p<0.001). Compared with non-exposure group, exposure groups (especially, orchard farmers) reported significantly more neurologic symptoms and had a higher overall neurological symptoms score (p<0.001). Factors related to the positive neurological symptoms (answers "yes" to six or more of Q-16 questionnaire) adjusted for age, sex, education level, smoking and alcohol drinking were type of farming (OR 3.08, 95% CI 1.50-6.30 in orchard farmers vs non-exposure group), CEI (OR 2.75, 95% CI 1.12-6.78 in Q3 vs Q1), past poisoning (OR 1.97, 95% CI 1.21-3.20 vs normal), current mild poisoning (OR 3.03, 9500 CI 1.47-6.22 vs normal) and current moderate poisoning (OR 6.34, 95% CI 3.03-13.25 vs normal), respectively. Conclusions: These results suggest that long-term exposure to pesticides appears to be associated with subtle changes in the central nervous system.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.5
• /
• pp.1047-1057
• /
• 1998

Background : Sarcoidosis is a systemic granulomatous disorder of unknown origin and characterized by accumulation of T cells and macrophages. Various cytokines may play crucial roles in the activation of T cells and macrophages, and thereby in the formation of granulomas. However, little is known about the balance between proinflammatory cytokines and antiinflammatory cytokines in the development of sarcoid granulomas and disease activities. In the present study, we measured IL-6, IL-8 and IL-10 in the bronchoalveolar lavage fluid(BALF) from patients with pulmonary sarcoidosis to find out whether there is an imbalance between proinflammatory cytokines and antiinflammatory cytokines in the lung. Methods: Fourteen subjects with the diagnosis of sarcoidosis and six healthy volunteers were included. BALF was concentrated ten-fold by pressure ultrafiltration and each cytokine levels were measured by EUSA method. Active sarcoidosis was defined by major organ involvement or clinically progressive diseases. Results: The mean IL-6 levels in the BALF of the active sarcoidosis group were significantly increased than in controls or inactive sarcoidosis group(p<0.05). Meanwhile, the IL-8 levels were increased and IL-10 levels were decreased in the active sarcoidosis group than in controls or inactive sarcoidosis group without significance(p>0.05). In active pulmonary sarcoidosis patients, the IL-6 levels in BALF correlated with the BALF CD4/CD8 ratio(r=0.768, p<0.05) and IL-8 levels(r=0.564, p<0.05). Conclusions : The data presented showed that pro-inflammatory cytokine IL-6 is important in the pathogenesis of sarcoidosis and decreased tendency of anti-inflammatory cytokine IL-10 might also be involved in the development of granulomatous inflammation in sarcoidosis.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.1
• /
• pp.26-33
• /
• 2006

Background: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. Methods: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. Results: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, $PaO_2$, $PaCO_2$, $SaO_2$ were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. Conclusion: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1981.05a
• /
• pp.41.2-41
• /
• 1981

Tonsillectomy and adenoidectomy are the most common operations in the ENT field. Recent emphasis on careful selection of patients for these procedures derives from concern for complications of surgery, as well as the immunologic and anatomic functions of tonsils and adenoids. Adenoidectomy can relieve nasopharyngeal airway obstruction caused by enlarge adenoids, and can prevent complications such as heart failure and recurrent or chronic otitis media. We researched 117 cases of tonsilloadenoidectomy patients and 266 patients having routine examination from March, 1979 to February, 1981, and described the A/N ratio derived from linear measurements of lateral radiographs of the nasopharynx. The results of Impedance Audiometry and X-ray films from 117 cases of T&A patients were compared: 1) The average A/N ratio by age groups for 266 cases of normal children showed: 0.508 for age group, 0 to 3 years old, 0.533 for age group, 4 to 6 years old, 0.524 for age group, 7 to 9 years old, 0.519 for age group, 10 to 12 years old, 0.507 for age group, 13 to 15 years old, 0.481 for age group over 15 years old. The peak value lies in the age group of 4 to 6 years old. The sex difference of A/N ratio was not significant. 2) The average A/N ratio by age groups from 117 cases of T&A patients showed: 0.709 for age group, 0 to 3 years old, 0.733 for age group, 4 to 6 years old, 0.693 for age group, 7 to 9 years old, 0.707 for age group, 10 to 12 years old, 0.620 for age group, 13 to 15 years old, 0.756 for age group over 15 years old. 3) Among the 117 cases of T&A patients, the average A/N ratio for 57 cases in normal tympanogram was 0.688 and the average A/N ratio for 60 cases in abnormal tympanogram was 0.705. 4) Among 57 cases in abnormal tympanogram: 6 cases (10.5%) showed 0.40-0.59 of A/N ratio, 44 cases (77.2%) showed 0.60-0.79 of A/N ratio, and 7 cases (12.3%) showed 0.80-0.99 of A/N ratio. 5) Among 117 cases of T&A patients, 3 of 15 cases showing A/N ratio under 0.6, and 67 of 102 cases showing A/N ratio over 0.6, had paranasal sinusitis.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.5
• /
• pp.433-439
• /
• 2006

Background: Although airway hyper-responsiveness is one of the characteristics of asthma. bronchial hyper-responsiveness has also been observed to some degree in patients with chronic obstructive pulmonary disease (COPD). Moreover, several reports have demonstrated that a number of patients have both COPD and asthma. The methacholine bronchial challenge test (MCT) is a widely used method for the detecting and quantifying the airway hyper- responsiveness, and is one of the diagnostic tools in asthma. However, the significance of MCT in differentiating asthma or COPD combined with asthma from pure COPD has not been defined. The aim of this study was to determine the role of MCT in differentiating asthma from pure COPD. Method: This study was performed prospectively and was composed of one hundred eleven patients who had undergone MCT at Chonbuk National University Hospital. Sixty-five asthma patients and 23 COPD patients were enrolled and their MCT data were analyzed and compared with the results of a control group. Result: The positive rates of MCT were 65%, 30%, and 9% in the asthma, COPD, and control groups, respectively. The mean $PC_{20}$ values of the asthma, COPD, and control groups were $8.1{\pm}1.16mg/mL$, $16.9{\pm}2.21mg/mL$, and $22.0{\pm}1.47mg/mL$, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT for diagnosing asthma were 65%, 84%, 81%, and 69%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT (ed note: please check this as I believe that these values correspond to the one $PC_{20}$ value. Please check my changes.) at the new cut-off points of$PC_{20}{\leq}16mg/ml$, were 80%, 75%, 78%, and 78%, respectively. Conclusion: MCT using the new cut-off point can be used as a more precise and useful diagnostic tool for distinguishing asthma from pure COPD.