Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitive disease showing various radiographic and clinical manifestations. Its clinical course has not been fully understood. Here I describe a case of a 23-year-old immunocompetent man with frequently relapsing ABPA. He was asthmatic. He visited our hospital because of a chronic cough. Laboratory examination showed eosinophilia with increased total and Aspergillus-specific IgE as well as positive skin reaction to Aspergillus fumigatus. Radiologic feature was a dense consolidation. Histology showed organizing pneumonia with eosinophilic infiltration. On the diagnosis of ABPA, he was treated with systemic steroid and itraconazole. Although treatment response was excellent, he suffered from recurrent ABPA three times thereafter in the form of fleeting mass-like consolidation.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.12
no.2
/
pp.205-211
/
1999
We studied 32 patents, who had visited Kyung Hee downtown oriental hospital with nasal obstruction. They has been observed their nasal cavity through anterior rhinoscopy. We had paten't middle and inferior turbinte bleeding by acupuncture. This symptom had been disappeared after this treatment. The result were as follows. 1. Sex and age distribution: The males were 18($56.2\%) and Female were 14($43.8\%$). The most common occurrence was found between 1-5 years old. 2. The most common duration of disease was between 2-6 months. 3. In decreasing order, the common complication & past history of otolaryngologic or allergic disease were allergic rhinitis, atopic dermatitis, chronic sinusitis, adenoid or tonsil hypertrophy, otitis media with effusion and asthma. 4. In descending order, distribution of symptoms were rhinorrhea, sneezing, dry sensation, sputum, frontal headach, postnasal drip and cough. 5. The improvement rate in symptom were $31.3\%\;excellent\;and\;53.1\%$ good.
Objectives: Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea. Methods: Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL. Results: Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than $10{\mu}m$ in diameter ($PM_{10}$). Lower social functioning scores were associated with high PM less than $2.5{\mu}m$ in diameter and nitrogen dioxide ($NO_2$) concentrations. High $NO_2$ concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when $PM_{10}$, $NO_2$, or ozone ($O_3$) concentrations were high, regardless of COPD severity. High $PM_{10}$ concentrations were associated with worsened wheezing, particularly in COPD patients. Conclusions: The results suggest that PM, $NO_2$, and $O_3$ cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.
Larygopharyngeal reflux(LPR) is one form of the Gastroesophageal Reflux Diseases(GERD). It is known to cause various kinds of otolaryngologic symptoms such as hoarseness, globus sensation in throat, chronic throat clearing, and chronic cough, Disease entities diagnosed by otolaryngologists as posterior laryngitis, globus pharyngeus and reflux laryngitis should be suspected as LPR-related diseases. The nizatidine(AXID), as a Histamine H2-receptor antagonist, reduces gastric acid secretion and improves gastric motility function. Objectives : The effect of nizatidine using 150mg b.i.d was evaluated for symptom relief and improvement of laryngoscopic findings in patients with LPR. Materials and Methods : In 30 multicenter, observational trial performed nationalwidely in Korea. 308 patients with LPR symptom were observed to evaluate their symptoms and larygnoscopic findings after 4weeks, 8weeks, 12weeks of treatment with nizatidine. Results : The symptoms of LPR including globus sensation, chronic throat clearing and hoarseness, are reduced significantly after 4 weeks, 8weeks, and 12weeks of treatment(p<0.05). The laryngoscopic findings including diffuse erythema, edema and granulation are improved after nizatidine treatment(p<0.05). and the efficacy of nizatidine on LPR-related sympoms after 4 weeks is 88.6%, and those of after 8 weeks and 12weeks were 92.6%, and 99.1% in ITT(Intent To Treatment) group(p<0.05). And PPA(Per Protocol Analysis)group showed 93.7%, 97.3%, and 99.1% of efficacy after 4, 8, and 12 weeks of nizatidine treatment(p<0.05). Conclusion : These results indicate that in patient with LPR, nizatidine 150mg b.i.d treatment very effectively reduces LPR symptoms and improves laryngoscopic findings as well as reduces gastric acid secretion and improves gastric motility function.
Kim, Kun Hyung;Cho, Hyun Min;Lee, Chan Kyu;Seok, JunePill;Kim, Seon Hee;Kim, Jung-Eun;Shin, Yu Kyung;Kim, Min Kyung
Journal of Acupuncture Research
/
v.35
no.2
/
pp.95-100
/
2018
Background: The aim of this study is to assess the feasibility of acupuncture treatment for the management of subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures. Methods: A total of 30 participants who have undergone thoracotomy after traumatic multiple rib fractures will be recruited. Participants will be invited and equally randomised into acupuncture plus usual care and usual care alone groups. A computer-generated random number sequence will be used and concealed using opaque, sealed, sequentially numbered envelopes. Twelve sessions of manual and electrical acupuncture performed by Korean medicine doctors will be provided over a span of 3 months to participants allocated to the acupuncture group. Participants in the usual care group will continue pain medication, exercise and physical therapy as required. Study feasibility will be measured based on the proportion of patients who complete the measurement of pain at 12 or 24 weeks after baseline. The clinical outcomes will include; the average pain intensity over the recent week at rest, movement and cough, quality of life, patient's global assessment of recovery, respiratory function measured by the pulmonary function test and use of pain medication at 4, 8, 12 and 24 weeks after enrolment. Adverse events will be recorded for all participants. Written informed consent will be obtained from all participants. The local ethics committee has approved the study. This pilot trial will inform further studies investigating the potential role of acupuncture for subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures.
A 2-year-old castrated male, Cocker spaniel dog with a history of chronic productive cough for 2 to 3 months and with unsuccessful treatment was referred to Veterinary Medical Teaching Hospital, Seoul National University. On thoracic radiographs, there were alveolar infiltrations at left cranial and right caudal lung fields, and soft-tissue opacity round to oval images at overall lung field. The bronchi were dilated, tortuous and not tapered. Abnormal air was accumulated focally in the caudodorsal lung fields. To scrutinize the soft-tissue opacity image and accumulated air, computed tomography (CT) was done. On CT images, severe cylindrical or tubular bronchiectasis was confirmed. And the soft-tissue opacity images were found in the dilated bilated and thought to complexes of mucous plugs, inflammatory cells, necrotic and fibrotic tissue. The dog was dead next day to the CT scan, so necropsy and histopathologic examination were perfermed. On the histopathology, there were cylindrical bronhiectasis and severe diffuse chronic fibrinous necropurulent bronchitis and bronchopneumonia. In this case, it was difficult to diagnose the bronchiectasis only with radiography due to the concurrent lesions, such as pulmonary infiltrations and mucous plugs, which was identified by computed tomography. Thus, computed tomography is considered as a useful modality to confirm tile bronchiectasis camouflaged by the concurrent lesion.
Background: Chronic eosinophilic pneumonia(CEP) presents with profound systemic symptoms, including fever, malaise, night sweats, weight loss, and anorexia together with localized pulmonary manifestations such as cough, wheeze, and sputum. It is an illness occurring predominantly in women. The chest radiogragh shows fluffy opacities that often have a characteristic peripheral configuration. The hallmark of CEP is the peripheral blood eosinophilia and a prompt response to oral corticosteroid therapy. We investigated characteristics of eleven patients of chronic eosinophilic pneumonia, reported in Korea. Method: There were eleven reports of CEP from 1980 to 1996, including three cases experienced in our hospital. The journals were analysed in respects of clinical history, laboratory, and radiographic findings. Results: 1) Male vs. female ratio is 3 : 8. The peak incidence occurred in forty and fifty decades. The atopic diseases were present in 6 cases. Asthma was the commonest manifestation 2) The presenting symptoms were as follows: cough, dyspnea, sputum, weight loss, fever, general weakness, night sweats, urticaria with the descending incidence. 3) Peripheral blood eosinophilia was present in all patients(mean ; 38.4%) and serum IgE level was elevated in nine patients(mean ; 880IU/ml). Conclusion: The diagnosis of chronic eosinophilic pneumonia is based on classic symptoms, including fever, night sweats, weight loss with a typical roentgenogram of peripheral pulmonary infiltrates and peripheral blood eosinophilia, and that is confimed by lung biopsy and/or bronchoalveolar lavage. Chronic eosinophilic pneumonia is responsive to corticosteroid promptly and recommended at least 6 months of therapy to prevent relapse.
As age distributions of developed countries grow increasingly top-heavy with elderly, instances of bronchiectasis and pneumonia increase. An elderly patient was diagnosed with pneumonia by radiational examination, which showed pound glass opacity in the right middle lobe. Also, he was diagnosed with bronchiectasis in the honeycomb-like recticular area of the right lower lobe. He said that he was suffering from a cough, phlegm and general weakness. He was treated by oriental medicine treatment exclusively, through herbal medicine and acupuncture therapy. Yukmijihwabg-Tang(六味地黃湯), Gamijinhae-Tang(加味鎭咳湯), and Samchulbobi-Tang(參朮補脾湯) As a result, symptoms of cough phlegm and general weakness improved considerably. These results suggest that oriental medicine treatment is effective in improving quality of life fer chronic respiratory patients.
Kim, Ki-Hoon;Cho, Hyung-Jun;Lee, Jin-Yong;Cho, Baek-Gun
The Journal of Pediatrics of Korean Medicine
/
v.18
no.1
/
pp.153-163
/
2004
Objective: For last 20 years our living environment has been changed rapidly. Accordingly. there have been many changes in prevalence of diseases; In nasal disease of the pediatrics, the number of children suffering from chronic rhinorrhea and nasal obstruction has been increased. And respiratory symptoms suggesting rhinitis and sinusitis also were increased. Allergic disease is considered as an important cause of this phenomenon while importance of infection as pathogen is fading today. The aim of this study is to investigate the effect of TonggyutangGarnibang on the nasal disease of children. Methods: Children with nasal disease answer the questionnaires on their chief complaints and medical past history on their first visit to our clinic. They were treated 'With TonggyutangGarnibang for 4weeks. After treatment they answered the questionnaire on improvement of their symptoms. Results: Among treated patients, 70 were male(69%) and 32 were female(31%); sex ratio was 2.2.3:l(male:female). And children from 3-8 years old took majority of patients(64%). Major symptoms of children with nasal disease were as follows; nasal obstruction 9lchildren(62%), rhinorrhea 86children(84%), sneezing 63children(62%), cough 63children(62%), snoring 48children (47%), poor appetite 44children(43%), itching 39children(38%), headache 32children(31%), stomache 25children(25%), epistaxis 23children(23%), constipation 17children(17%), diarrhea 12children(12%). Past history and impression of the disease of the patients were as follows; allergic rhinitis(66%), atopic dermatitis(42%), sinusitis(40%), asthma(25%), urticaria(12%). Severity of symptom improved after TonggyutangGamibang treatment, it showed high treatment efficacy as follows; sneezing 70%, cough 70%, rhinorrhea 63%, nasal obstruction 59% Conclusion: This study shows TonggyutangGamibang has distinctive treatment effect on children with nasal disease.
Noh, Seung Ho;Lee, Yong Woo;Park, Jin Su;Lee, Sang Hyuk
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
/
v.28
no.1
/
pp.43-47
/
2017
Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.
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