• Title/Summary/Keyword: Bronchodilator

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A Case of Endobronchial Carcinoid Tumor Treated by Flexible Bronchoscopic Resection (기관지내시경 절제술로 치료한 기관지 카르시노이드 종양 1예)

  • Na, Yong-Sub;Yoon, Sung-Ho;Lee, Seung-Il;Kwon, Yong-Eun
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.6
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    • pp.516-520
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    • 2011
  • Bronchial carcinoid tumor accounts for less than 5% of all primary lung tumors in adults. Although surgical resection is the treatment of choice, here we report a case of bronchial carcinoid tumor treated with flexible bronchoscopic resection. A 19-year-old-man presented with a history of wheezing with dyspnea for six months. A simple chest x-ray showed no abnormal findings, but a pulmonary function test showed a moderate obstructive lung disease pattern without a bronchodilator response. A computed tomogram of the thorax revealed an enhanced $15{\times}12$ mm nodule in the left main bronchus. Bronchoscopic examination showed a polypoid mass with a stalk in the left main bronchus, which almost completely occluded the left main bronchus. Histopathology of the resected specimen revealed a bronchial carcinoid tumor. We treated the carcinoid tumor with a flexible bronchoscopic resection. During the follow up period of 6 months, the previous tumor didn't relapse. Initial bronchoscopic resection should be considered when bronchial carcinoid tumor can be approached by bronchoscopy.

Chronic Obstructive Pulmonary Disease with Severe Pulmonary Hypertension - A Case Report - (중증 폐동맥고혈압이 동반된 만성폐쇄성폐질환 1 예)

  • Park, Chan-Soh;Chin, Hyun-Jung;Kim, Seok-Min;Son, Chang-Woo;Yu, Sung-Ken;Chung, Jin-Hong;Lee, Kwan-Ho
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.50-57
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    • 2008
  • Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

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A case of bronchiolitis obliterans developed after adenovirus type 7 pneumonia (7형 아데노바이러스 폐렴 후 발생한 폐쇄 세기관지염 1례)

  • Park, Hyo-Khan;Lee, So-Yeon;Kim, Young-Ho;Oh, Phil-Soo;Kim, Jae-Yoon;Jung, Yoon-Seok;Kang, Chun;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.124-128
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    • 2007
  • Bronchiolitis obliterans is a clinical syndrome of chronic obstruction associated with inflammatory changes in the small airways. There are marked variations in the epidemiology of this disease. In childhood, bronchiolitis obliterans has been described as a result of a number of infections such as adenovirus, measles, Bordetella pertussis, Mycoplasma pneumoniae, and influenza A infection. Most common agents are adenovirus types 3, 7, and 21. Diagnosis of bronchiolitis obliterans can be made based on clinical findings, high resolution computed tomography (HRCT) and lung biopsy. In addition to diagnosis, treatment is not yet clearly established. The authors experienced a case of bronchiolitis obliterans developed in 3 year-old girl who suffered from type 7 adenoviral pneumonia. She had been hospitalized and treated for 15 days due to pneumonia. After discharge, productive cough was not improved and auscultation revealed wheezing. HRCT demonstrated multifocal mosaic patterns suggesting bronchiolitis obliterans. She was managed with inhaled steroid and bronchodilator, and her symptoms were improved. However, follow up HRCT showed no interval change.

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Effects of Enoxacin and Ciprofloxacin on the Theophylline Metabolism in Humans (Enoxacin과 Ciprofloxacin이 Theophylline 대사에 미치는 영향에 대한 연구)

  • Choi, Soo-Jeon;Lee, Bong-Choon;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.4
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    • pp.372-378
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    • 1991
  • Some kinds of newer fluoroquinolone antibiotics are known to interact with theophylline, which is widely used as a potent bronchodilator in asthma or chronic obstructive lung disease. To evaluate the effect of enoxacin and ciprofloxacin on the metabolism of theophylline, aminophylline was administered intravenously in bolus (6 mg/kg) over 30 minutes to 6 healthy volunteers (age: $23.3{\pm}4.2$ year, body weight: $63.2{\pm}9.0\;kg$, height: $169.0{\pm}6.5\;cm$, female 3, male 3) before and after per oral 5-day medication of enoxacin and ciprofloxacin, respectively and we measured the level of theophylline in serum. The results were as follows: 1) Enoxacin and ciprofloxacin did not influence the volume of distribution significantly. 2) Enoxacin decreased the clearance of theophylline significantly (from $42.9{\pm}14.6\;ml/min$ to $30.1{\pm}6.3\;ml/min$: p<0.05), but ciprofloxacin did not cause significant decrease (to $32.8{\pm}6.2\;ml/min$: p>0.005). 3) Enoxacin increased the elimination half life of theophylline significantly (from $496{\pm}83\;min$ to $693{\pm}32\;min$: p<0.001), but ciprofloxacin did not cause significant increase (to $687{\pm}222\;min$: p>0.05). These results suggested that enoxacin influenced clearance and elimination half life significantly and thorough monitoring of the level of theophylline in patients with coadminstration of enoxacin and theophylline was necessary. In case of ciprofloxacin, the influence on the metabolism of theophylline was not statistically significant, but one exceptionally large decrease of the clearance and increase of the elimination halflife of theophylline suggested the necessity of monitoring of theophylline level during coadministration of ciprofloxacin and theophylline.

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The Actual State of Hospital-based Skill Training in Level 1 Emergency Medical Technician (소방 1급응급구조사의 병원임상수련 술기 실태 조사)

  • Roh, Sang-Gyun;Lee, Jae-Gook;Bang, Sung-Hwan
    • Fire Science and Engineering
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    • v.26 no.5
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    • pp.54-60
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    • 2012
  • This study is the analysis of the actual state of hospital-based training in level 1 emergency medical technicians (EMTs) in fire station. The survey was carried out to 42 fire fighters having level 1 emergency medical technician certification from May 11 to 12 in 2012. The results showed 56.5 %, that the level 1 EMTs of roles had direct experienced. Level 1 EMTs performance frequency of clinical practice that endotracheal intubation 66.9 %, laryngeal mask airway 8.4 %, intravenous access 76.6 %, nitroglycerin sublingual 61.2 %, bronchodilator inhalation 50.0 %, fluid loading 73.8 %, ventilator apply 57.6 %, dextrose injection 57.6 %. It is necessary to investigate the continuous study on the education among the level 1 EMTs and the continuous evaluation and analysis of problems, supplemented of guidebook, practical education programs and regulation upon the operation and management of a hospital-based skill training.

Tracheobronchial Foreign Body in a Shih-tzu Dog; Diagnostic and Therapeutic Trial Using Bronchoscopy (시츄견에서 발생한 기관기관지 이물의 기관지경을 통한 진단적 및 치료적 적용 증례)

  • Park, Chul;Yoo, Jong-Hyun;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.336-339
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    • 2009
  • A 4-year-old, neutered male Shih-tzu dog weighing 5.4 kg was referred due to anorexia and chronic coughing. Based on history, physical examination, laboratory tests, radiographic findings, echocardiography, and bronchoscopic examination, the dog was diagnosed as tracheobronchial foreign body. The foreign body was steamed rice debris, which was removed by bronchoalveolar lavage (BAL) with vacuum suction of bronchoscopy. Bacterial and fungal culture of collected BAL fluid was negative. Baermann test for lungs parasites also was negative. The dog was treated with bronchodilator, antibiotics, anti-inflammatory agent, and mucolytics for 7 days. Appetite increased and coughing sign was clearly improved after removal of foreign body and medical therapy. This case report describes that bronchoscopic techniques are available for the evaluation and management of airway foreign bodies.

Anti-Proliferative Activities of Vasicinone on Lung Carcinoma Cells Mediated via Activation of Both Mitochondria-Dependent and Independent Pathways

  • Dey, Tapan;Dutta, Prachurjya;Manna, Prasenjit;Kalita, Jatin;Boruah, Hari Prasanna Deka;Buragohain, Alak Kumar;Unni, Balagopalan
    • Biomolecules & Therapeutics
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    • v.26 no.4
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    • pp.409-416
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    • 2018
  • Vasicinone, a quinazoline alkaloid from Adhatoda vasica Nees. is well known for its bronchodilator activity. However its anti-proliferative activities is yet to be elucidated. Here-in we investigated the anti-proliferative effect of vasicinone and its underlying mechanism against A549 lung carcinoma cells. The A549 cells upon treatment with various doses of vasicinone (10, 30, 50, $70{\mu}M$) for 72 h showed significant decrease in cell viability. Vasicinone treatment also showed DNA fragmentation, LDH leakage, and disruption of mitochondrial potential, and lower wound healing ability in A549 cells. The Annexin V/PI staining showed disrupted plasma membrane integrity and permeability of PI in treated cells. Moreover vasicinone treatment also lead to down regulation of Bcl-2, Fas death receptor and up regulation of PARP, BAD and cytochrome c, suggesting the anti-proliferative nature of vasicinone which mediated apoptosis through both Fas death receptors as well as Bcl-2 regulated signaling. Furthermore, our preliminary studies with vasicinone treatment also showed to lower the ROS levels in A549 cells and have potential free radical scavenging (DPPH, Hydroxyl) activity and ferric reducing power in cell free systems. Thus combining all, vasicinone may be used to develop a new therapeutic agent against oxidative stress induced lung cancer.

Increased B cell-activating factor (BAFF) level in the sputum of children with asthma

  • Jee, Hye-Mi;Choi, Bong-Seok;Kim, Kyung-Won;Sohn, Myung-Hyun;Han, Man-Yong;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.795-800
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    • 2010
  • Purpose: B cell-activating factor (BAFF) is a tumor-necrosis factor (TNF) superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is observed in naive cells as well as in effector/memory T cells. We aimed to explore whether BAFF in sputum is expressed at elevated levels in asthmatic airways and associated with eosinophilic inflammation, pulmonary function, and bronchial hyperresponsiveness in children. Methods: One hundred and fifty-four asthmatic children and 98 healthy children were enrolled in the study. Sputum supernatants were collected and sputum BAFF and eosinophil cationic protein (ECP) levels were measured. We performed pulmonary function tests and methacholine challenge tests, while measuring total eosinophil count, total serum IgE, and serum ECP in all subjects. Results: Asthmatic children had significantly higher levels of BAFF in induced sputum [26.50 (10.50-100.27) pg/mL] compared to healthy children [18.32 (7.68-44.63) pg/mL; $P$=0.011]. Sputum BAFF positively correlated with sputum eosinophils (${\gamma}$=0.406, $P$<0.001) and sputum ECP (${\gamma}$=0.789, $P$<0.001). Significant negative correlations were found between sputum BAFF and FEV1 (${\gamma}$=-0.291, $P$<0.001) or post-bronchodilator FEV1 (${\gamma}$=-0.334, $P$<0.001), whereas nonsignificant correlations were found between sputum BAFF and bronchial hyperresponsiveness, serum eosinophil count, and serum ECP. Conclusion: These findings suggest that BAFF may play a role in childhood asthma, and BAFF levels in sputum could be a supportive marker that represents airway inflammation, especially eosinophilic inflammation.

Prescription Patterns and Factors Related to the Number of Medications in Chronic Obstructive Pulmonary Disease in Non-elderly Adults (비고령 성인환자의 만성폐쇄성폐질환 약물사용 현황과 영향인자)

  • Moon, Chae-won;Ra, Hyun-O;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.298-305
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    • 2016
  • Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

A Case of Pulmonary Injuny Induced by Accidental Exposure to High Level of Nitrogen Dioxide ($NO_2$) (고농도의 이산화질소($NO_2$)흡입으로 유발된 급성 폐손상 1례)

  • Chang Jin Hyuck;Kim Do Youn;Kim Young;Chang Yoon Soo;Kim Hyung Jung;Ahn Chul Min;Kim Sung Kyu;Kim Tae Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.40-44
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    • 2005
  • Nitrogen dioxide ($NO_2$), which produced during the process of silage, metal etching, explosives, rocket fuels, welding, and by-product of burning of fossil fuels, is one of major components of air pollutant. Accidental exposure of high level of $NO_2$ produces cough, dyspnea, pulmonary edema which may be delayed $4\~12$ hours and, in $2\~6$weeks, bronchiolitis obliterans. We experienced a case of acute pulmonary injuny induced by industrial exposure to high level of $NO_2$ during repair of $NO_2$ pipeline in a refinery. A 55-year-old man experienced nausea and severe dyspnea in 6 hours after $NO_2$ inhalation. Initial blood gas examination revealed severe hypoxemia accompanying increased alveolar-arterial O2 difference. Radiological examination showed diffuse ground glass opacities in both lung fields. Clinical symptoms and laboratory findings, including radiological study and pulmonary function test were improved with conservative treatment using inhaled oxygen and bronchodilator. and there was no evidence of bronchial fibrosis and bronchiolitis obliterance in chest high resolution computed tomography performed 6 weeks after exposure. Here, we report a case of $NO_2$ induced acute pulmonary injuny with a brief review of the relevant literature.

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