• 제목/요약/키워드: Acute asthma

검색결과 98건 처리시간 0.024초

폐쇄성 폐질환에 동반된 성대 운동이상에 의한 기능성 상기도폐색 1예 (A Case of Functional Upper Airway Obstruction Due to Vocal Cord Dysfunction in Obstructive Pulmonary Disease)

  • 오명;김상철;백재중;정연태
    • Tuberculosis and Respiratory Diseases
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    • 제51권3호
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    • pp.270-274
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    • 2001
  • 성대 운동이상에 의한 상기도 폐색은 드문질환으로 저자들은 호흡곤란을 주소로 내원한 61세 여자환자에서 기관지내시경검사와 폐기능검사로 폐쇄성폐질환에 동반된 성대 운동이상에 의한 기능성상기도 폐색증을 확진하고 이완요법(relaxation)과 산소공급으로 증상이 호전되어 퇴원후 외래에서 추적관찰중인 1예를 경험하여 이를 문헌고찰과 함께 보고하는 바이다.

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Inhibition of Inducible Nitric Oxide Synthase and Cyclooxygenase-2 by Gamijihwang-tang Via Suppression of Nuclear Factor-B Activation in RAW 264.7 cells

  • Jang Du-Hyun;Kim Ji-Young;Han Eun-Hee;Park Hee-Ok;Kim Dong-Hee;Jeong Hye-Gwang;Yoo Dong-Yeol
    • 동의생리병리학회지
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    • 제19권5호
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    • pp.1405-1410
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    • 2005
  • Asthma is recognized today as an inflammatory disease of the lung characterized by acute non-specific airway hypersensitiveness in association with chronic pulmonary inflammation. Gamijihwang-tang(GJT), a fortified prescription of YMJHT, is applied for the treatments of chronic coughing and asthma, and post-delivery coughing and asthma in the gynecology. Also in the clinical practice, GJT is known to be very effective for controlling coughing and asthma as a cold sequoia. In this study, we investigated the effects of GJT on the lipopolysaccharide (LPS)-induced nitric oxide (NO) and prostaglandin $E_2$ ($PGE_2$) production, and on the level of inducible nitric oxide synthase (iNOS) and Cyclooxygenase-2 expression in murine macrophage RAW 264.7 cells. We found that GJT inhibited LPS-induced NO and $PGE_2$ production in a dose dependent manner. Furthermore, GJT inhibited the expression of LPS-induced iNOS and COX-2 protein and mRNA expression in RAW 264.7 macrophages. Treatment with GJT of RAW 264.7 cells transfected with a reporter construct indicated a reduced level of LPS-induced nuclear factor-KB (NF-kB) activity and effectively lowered NF-kB binding as measured by transient transfection assay. These results suggest that the main inhibitory mechanism of the GJT may be the reduction of iNOS and COX-2 gene expression through blocking of NF-kB activation.

Tiotropium Bromide Has a More Potent Effect Than Corticosteroid in the Acute Neutrophilic Asthma Mouse Model

  • An, Tai Joon;Kim, Ji Hye;Park, Chan Kwon;Yoon, Hyoung Kyu
    • Tuberculosis and Respiratory Diseases
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    • 제85권1호
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    • pp.18-24
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    • 2022
  • Background: Neutrophilic asthma (NeuA) is usually resistant to corticosteroids. Tiotropium bromide (TIO) is a bronchodilator that is used as an add-on therapy to inhaled corticosteroid and long-acting β2 agonist in asthma treatment. However, the role of TIO in NeuA is not fully known. Thus, the aim of this study was to evaluate the effect of TIO on NeuA compared to that of corticosteroids. Methods: C57BL/6 female mice were sensitized with ovalbumin and lipopolysaccharide to induce neutrophilic inflammation. Dexamethasone (DEX) was administered on days 14, 17, 20, and 23. TIO was inhaled on days 21, 21, and 23. On day 24, mice were sacrificed. Airway hyper-responsiveness, levels of cytokines in bronchoalveolar lavage (BAL) and lung homogenates, and lung tissue histopathology were compared between the two groups. Results: Neutrophil counts, T helper 2 cells (TH2)/TH17 cytokines, and pro-inflammatory cytokine in BAL fluids were elevated in the NeuA group. TIO group showed lower total cells, neutrophil counts, and eosinophil counts in BAL fluids than the DEX group (p<0.001, p<0.05, and p<0.001, respectively). Airway resistance was attenuated in the TIO group but elevated in the NeuA group (p<0.001). Total protein, interleukin (IL)-5, and IL-17A levels in BAL fluids were lower in the TIO group than in the NeuA group (all p<0.05). Conclusion: TIO showed more potent effects than DEX in improving airway inflammation and attenuating airway resistance in NeuA.

Ginsenoside Rg3 ameliorates allergic airway inflammation and oxidative stress in mice

  • Huang, Wen-Chung;Huang, Tse-Hung;Yeh, Kuo-Wei;Chen, Ya-Ling;Shen, Szu-Chuan;Liou, Chian-Jiun
    • Journal of Ginseng Research
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    • 제45권6호
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    • pp.654-664
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    • 2021
  • Background: Ginsenoside Rg3, isolated from Panax ginseng, has anti-inflammatory and anti-tumor activities. It is known to reduce inflammation in acute lung injury in mice, and to reduce the expression of inflammatory cytokines and COX-2 in human asthmatic airway epithelium. In this study, we attempted to determine whether ginsenoside Rg3 inhibits airway inflammation, oxidative stress, and airway hyperresponsiveness (AHR) in the lungs of asthmatic mice. We also investigated its effects on oxidative stress and the inflammatory response in tracheal epithelial cells. Methods: Asthma symptoms were induced in female BALB/c mice sensitized with ovalbumin (OVA). Mice were divided into five groups: normal controls, OVA-induced asthmatic controls, and asthmatic mice treated with ginsenoside Rg3 or prednisolone by intraperitoneal injection. Inflammatory BEAS-2B cells (human tracheal epithelial cells) treated with ginsenoside Rg3 to investigate its effects on inflammatory cytokines and oxidative responses. Results: Ginsenoside Rg3 treatment significantly reduced eosinophil infiltration, oxidative responses, airway inflammation, and AHR in the lungs of asthmatic mice. Ginsenoside Rg3 reduced Th2 cytokine and chemokine levels in bronchoalveolar lavage fluids and lung. Inflammatory BEAS-2B cells treated with ginsenoside Rg3 reduced the eotaxin and pro-inflammatory cytokine expressions, and monocyte adherence to BEAS-2B cells was significantly reduced as a result of decreased ICAM-1 expression. Furthermore, ginsenoside Rg3 reduced the expression of reactive oxygen species in inflammatory BEAS-2B cells. Conclusion: Ginsenoside Rg3 is a potential immunomodulator that can ameliorate pathological features of asthma by decreasing oxidative stress and inflammation

High-flow nasal cannula oxygen therapy in children: a clinical review

  • Kwon, Ji-Won
    • Clinical and Experimental Pediatrics
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    • 제63권1호
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    • pp.3-7
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    • 2020
  • High-flow nasal cannula (HFNC) is a relatively safe and effective noninvasive ventilation method that was recently accepted as a treatment option for acute respiratory support before endotracheal intubation or invasive ventilation. The action mechanism of HFNC includes a decrease in nasopharyngeal resistance, washout of dead space, reduction in inflow of ambient air, and an increase in airway pressure. In preterm infants, HFNC can be used to prevent reintubation and initial noninvasive respiratory support after birth. In children, flow level adjustments are crucial considering their maximal efficacy and complications. Randomized controlled studies suggest that HFNC can be used in cases of moderate to severe bronchiolitis upon initial low-flow oxygen failure. HFNC can also reduce intubation and mechanical ventilation in children with respiratory failure. Several observational studies have shown that HFNC can be beneficial in acute asthma and other respiratory distress. Multicenter randomized studies are warranted to determine the feasibility and adherence of HFNC and continuous positive airway pressure in pediatric intensive care units. The development of clinical guidelines for HFNC, including flow settings, indications, and contraindications, device management, efficacy identification, and safety issues are needed, particularly in children.

입원한 천식 환아들의 흉부 방사선 소견과 무기폐 (Radiographic Findings and Atelectasis in Children Admitted to Hospital with Acute Asthma)

  • 정유진;박혜진;이경일;이원배;양동헌
    • Clinical and Experimental Pediatrics
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    • 제45권4호
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    • pp.519-523
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    • 2002
  • 목 적: 기관지 천식으로 입원한 환아에서 시행된 단순 흉부 방사선에서 이상 소견을 조사하고, 관찰된 무기폐를 자세히 분석하고자 하였다. 방 법 : 4년간 가톨릭대학교 대전성모병원에 기관지 천식으로 입원한 144명의 357례의 흉부 방사선에서 무기폐를 포함한 폐의 이상 소견과 임상상, 혈액학적 소견 등을 후향적으로 분석하였다. 결 과 : 144례의 환아의 남녀비는 2.1 : 1, 평균 나이는 4.8세, 평균 입원 횟수 2.5회, 평균 입원일 5.0일, 평균 IgE 치 387 IU/mL, 평균 호산구 수 $362/mm^3$ 이었다. 357례의 단순 흉부 방사선 이상 소견으로 과?창 314례(88.0%), 폐침윤 127례(35.0%), 무기폐 19례(5.3%), 중격동기종 1례(0.3%)가 관찰되었다. 19례의 무기폐는 대부분 폐구역성 또는 폐소엽성으로 모두 우측 폐에서 발생하였으며 2세 이하와 남아에서 발생이 많았다. 또한 2세 이하에서는 우상엽에서, 7세 이상에서는 우하엽에서 주로 발생하였다. 결 론 : 천식으로 입원한 환아에서 흉부 방사선 사진에서 무기폐(5.3%)를 포함한 이상 소견을 보이는 경우가 적지 않으며 이에 따른 적절한 치료 방침을 결정해야 할 것으로 사료된다.

소아 천식과 폐렴에서 혈청 vascular endothelial growth factor 농도의 의의 (The significance of vascular endothelial growth factor(VEGF) in children with asthma and pneumonia)

  • 최성환;심정연;유명환;김덕수;심재원;정혜림;박문수
    • Clinical and Experimental Pediatrics
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    • 제49권2호
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    • pp.192-197
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    • 2006
  • 목 적 : 천식은 기도의 만성 염증성 질환으로 기도개형은 천식에서 가장 중요한 병태생리이다. 혈관의 신생 및 혈관투과성을 증가시키는 것으로 알려진 VEGF가 천식의 중증도와 기침의 지속기간에 따라 차이가 있는지 알아보고, 폐렴과 같은 급성 하기도 질환에서도 증가하는지 알아보고자 하였다. 방 법 : 2001년 1월부터 2002년 1월까지 강북삼성병원 소아과에 천식 및 폐렴으로 내원한 36명의 환아와 건강검진을 위해 소아과 외래를 방문한 건강한 어린이 22명을 대상으로 하였다. 천식 환아는 중증도에 따라 경증 천식군과 중등증 및 중증 천식의 두 군으로 나누고, 또한 내원 시까지의 기침의 지속기간에 따라 2주 미만, 2주에서 4주, 4주 이상의 세 군으로 분류한 후 각각 혈청 VEGF 농도를 비교하였으며, 혈소판 및 백혈구수, CRP, IgE 농도, 총호산구수, 대상군의 나이와의 상관관계를 조사하였다. 결 과 : 평균 혈청 VEGF 농도는 경증 천식군, 중등증 및 중증 천식군, 폐렴군, 대조군에서 각각 $278.4{\pm}191.6pg/mL$, $751.6{\pm}534.2pg/mL$, $775.6{\pm}340.0pg/mL$, $311.2{\pm}198.1pg/mL$로 중등증 및 중증 천식군과 폐렴군에서 경증 천식군 및 대조군보다 혈청 VEGF 농도가 유의하게 높았다(P<0.05). 기관지 천식을 앓고 있는 환아 중 기침 기간에 따라 혈청 VEGF 농도를 비교해 본 결과 2주 이상 4주 이하 동안 기침을 한 군 및 4주 이상 기침을 한 군에서 혈청 VEGF 농도는 각각 $709.2{\pm}589.3pg/mL$, $896.9{\pm}594.9pg/mL$로 2주 미만 기침을 한 그룹의 $307.1{\pm}198.4pg/mL$에 비하여 의미있게 높았다(P<0.05). 혈청 VEGF 농도와 혈소판 수치 및 백혈구수와는 양의 상관관계를 보였으며(P<0.05), CRP, IgE 농도, 총호산구수 및 대상군의 나이와는 의미 있는 상관관계가 없었다. 결 론 : 혈청 VEGF는 기관지 천식에서 중증도 및 염증의 지속기간과 연관이 있으며, 급성 하기도 질환의 급성 염증반응에도 중요한 역할을 한다.

소아 부비동염 진단 (The diagnosis of pediatric sinusitis)

  • 김창근
    • Clinical and Experimental Pediatrics
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    • 제50권4호
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    • pp.323-327
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    • 2007
  • Although most clinicians now agree that sinusitis can afflict children of all ages, appropriate diagnosis remain controversial. Sinusitis is one of the most challenging diagnoses for a clinician, because there is a lack of validated diagnostic criteria for acute rhinosinusitis. Symptoms generally include nasal congestion, purulent nasal discharge, and cough .The physical examination is often unsuccessful in confirming the diagnosis. If purulent discharge is seen oozing from the middle meatus, the diagnosis of acute rhinosinusitis is almost certain. Purulent drainage may also be seen in the posterior pharynx and accompanied by halitosis. Absence of light by transillumination may indicate acute rhinosinusitis. Imaging studies are not necessary to confirm the diagnosis of sinusitis in children younger than 6 years and should be used sparingly in children older than 6 years. Sinus radiographs still have several advantages over CT scanning including the relatively low cost and the ability to obtain films without the use of sedation in younger children. Positive findings of sinusitis on plain film include air-fluid levels, complete opacification, or mucosal thickening greater then 4 mm. The CT scan however, is significantly more sensitive then plain films in detecting these abnormalities. Although recovery of bacteria from a sinus aspiration is considered reference standard for diagnosis in pediatric rhinosinusitis, its routine used by pediatricians is not practical and therefore is not recommended.

Effectiveness and safety of seasonal influenza vaccination in children with underlying respiratory diseases and allergy

  • Kang, Jin-Han
    • Clinical and Experimental Pediatrics
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    • 제57권4호
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    • pp.164-170
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    • 2014
  • Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

소아의 급성 폐 및 기도질환의 영상 (Imaging of Acute Pulmonary and Airway Diseases in Children)

  • 이미정;신현주;윤혜성
    • 대한영상의학회지
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    • 제81권4호
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    • pp.756-769
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    • 2020
  • 소아의 다양한 응급질환 중 급성 폐질환 또는 급성 기도질환은 영상의학과 의사가 자주 대하게 되는 임상 상황이며, 일차적으로 시행되는 영상검사는 흉부 방사선사진이다. 따라서 다양한 임상 상황에서의 감별진단과 영상 소견을 숙지하는 것이 중요하다. 본 종설에서는 급성폐질환의 다양한 원인과 폐렴을 알아보고, 폐렴과 감별해야 하는 급성 폐질환을 생각해보았다. 급성 기도질환으로는 크룹, 급성 후두염, 기관연화증, 천식, 감염 후 폐쇄세기관지염, 그리고 이물 흡인을 검토하였다. 이렇게 소아에서 고려해야 할 질환들의 영상 소견을 검토하여 진단과 치료에 도움을 줄 수 있길 바란다.