• 제목/요약/키워드: Cough

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Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients (수정된 연하곤란사정도구와 비디오 연하영상 조영술의 흡인 위험 예측비교)

  • Moon, Kyung-Hee;Sohn, Hyun-Sook;Lee, Eun-Seok;Paek, Eun-Kyung;Kang, Eun-Ju;Lee, Seung-Hee;Han, Na-Ri;Lee, Meen-Hye;Kim, Deog-Young;Park, Chang-Gi;Yoo, Ji-Soo
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.359-366
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    • 2010
  • Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

Effects of the Neck Stabilizing Exercise Combined With the Respiratory Reeducation Exercise on Deep Neck Flexor Thickness, Forced Vital Capacity and Peak Cough Flow in Patients With Stroke (목 안정화와 호흡 재교육 운동이 만성 뇌졸중 환자의 목 깊은 굽힘근육의 두께, 노력성 폐활량과 최대 기침 유량에 미치는 효과)

  • Lee, Myoung-Hyo;Hwang-bo, Gak
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.19-29
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    • 2015
  • Impaired respiratory function is common in patients with stroke. The purpose of this study were to investigate the effectiveness of exercises and to assess forced vital capacity and peak cough flow after completion of neck stabilizing and respiratory reeducation exercises (combining diaphragmatic breathing and pursed-lip breathing exercises). The 45 participants were randomly assigned to an experimental group 1 ($n_1=15$), experimental group 2 ($n_2=15$), and a control group ($n_3=15$). All subjects performed conservative physical therapy for 30 minutes. Experimental group 1 undertook the neck stabilizing exercise and the respiratory reeducation exercise. Experimental group 2 undertook the respiratory reeducation exercise. Additional exercise did not exceed 30 minutes, five times a week for six weeks. The subjects were assessed for deep neck flexor thickness and breathing function (forced vital capacity, forced expiratory volume at one second, forced expiratory volume at one second/forced vital capacity, peak expiratory flow, and manual assisted peak cough flow) at pre-post value. The results of this study were as follows. Experimental group 1 showed a significant increase only in deep neck flexor thickness change rate (p<.05). All groups showed significant increases in forced vital capacity, forced expiratory volume at one second, and peak expiratory flow in pre-post measurement (p<.05). Experimental groups 1 and 2 showed an increase in manual assisted peak cough flow in pre-post measurement (p<.05). There was no significant difference between experimental group 1 and experimental group 2, but experimental group 1 improved more than experimental group 2 in respiratory function as a whole. In conclusion, these findings suggest that the neck stabilizing exercise in combination with the respiratory reeducation exercise can improve forced vital capacity and peak cough flow in patients with stroke.

The Characteristics of the Hyangyak medicine in the early period of Chosun through 「Various Coughs section」 in 『Hyangyakjipseongbang』 (『향약집성방(鄕藥集成方)』 「제해문(諸咳門)」에 나타난 조선전기(朝鮮前期) 향약의학(鄕藥醫學)의 특징)

  • Kang, Yeon Seok;Ahn, Sang Woo
    • The Journal of Korean Medical History
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    • v.16 no.1
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    • pp.3-16
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    • 2003
  • In researches done previously, the characteristics of the Hyangyak medicine in the early period of Chosun shown in "HyangyakBoncho(鄕藥本草)" in Vol. 76-85 of "Hyangyakjipseongbang(鄕藥集成方)" and "Sanghan section(傷寒門)" in Vol. 5-8 of "Hyangyakjipseongbang(鄕藥集成方)" was investigated. "Cough section(咳嗽門)" in "Various Diseases volume" of "Dongeuibogam(東醫寶鑑 雜病篇)" Vol. 5 and "Various Coughs section(諸咳門)" of "Hyangyakjipseongbang(鄕藥集成方)" Vol 24-25 which is a paragraph related to "Sanghan section(傷寒門)" was compared. The variety of the Hyangyak, processing methods and forms of the Hyangyak were shown by comparing each oriental medical botany(本草) used for treating cough(咳嗽) in "Dongeuibogam(東醫寶鑑)". Subsequently, the difference between each structure and medical theory was speculated. The facts revealed in this research is as follows. First, [Various Coughs section(諸咳門)] of "Hyangyakjipseongbang(鄕藥集成方)" uses only the Hyangyak, and no foreign medicines were used for treating cough(咳嗽) in "Dongeuibogam(東醫寶鑑)". Second, in [Various Coughs section(諸咳門)] of "Hyangyakjipseongbang(鄕藥集成方)", medicines related to diet and medicines taken raw were widely used, and various forms of medicine such as extracts, plasters, and gruels were used. Third, like other medical books in earlier periods, [Various Coughs section(諸咳門)] of "Hyangyakjipseongbang(鄕藥集成方)" describes the medical theory with conciseness, and keeps the structure of symptom classification focused on treatment and prescription. Fourth, as [Hyangyakboncho(鄕藥本草)] extensively uses the knowledge of oriental medical botany(本草) from two of Four Masters of GeumWon(金 元); JangWonSo(張元素) and LeeDongWon(李東垣), "Various Coughs section(諸咳門)" of "Hyangyakjipseongbang(鄕藥集成方)" quotes the books of JuDanGae but does not adopt the theory and prescriptions of 'replenishing yin and downbearing fire (滋陰降火)'. To find a more descriptive picture of the Hyangyak medicine for the treatment of 'cough(咳嗽)', a comparatitive study between the books written in the same period -"Euibangyuchui(醫方類聚)" and books compilated in China should be done, and there should be more profound researches done on individual medicines and prescriptions.

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Chemokines Expression in Children with a Non-productive Cough (소아기 단순 기침 환아에서의 케모카인 발현 양상 연구)

  • Lee, Young-Hwan;Kim, Hee-Sun
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.129-136
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    • 2007
  • Purpose : To evaluate the chemokine expression in children with a non-productive cough. Materials and Methods : Six children with a non-productive cough who visited Yeungnam University Hospital were evaluated for the mRNA expression of interferon-${\gamma}$-inducible protein 10(IP-10), macrophage cationic protein 1 and 3 (MCP-1, 3), interleukin (IL)-8, regulated upon activation in normal T cells expressed and secreted (RANTES), eotaxin and growth-related oncogene-${\alpha}$ (Gro-${\alpha}$) using the reverse transcription polymerase chain reaction. Results : The chemokines IP-10 and MCP-3 were expressed in all samples. The chemokine RANTES was expressed in five cases, and IL-8 was expressed in three among them. However, eotaxin, Gro-${\alpha}$ and MCP-1 were not expressed at all. The expression of chemokine MCP-3, RANTES and IL-8 were suppressed after the resolution of coughing in just one available case. Conclusion : The chemokines MCP-3, RANTES and IL-8 may contribute to airway inflammation in children with a non-productive cough, whereas IP-10 is of secondary importance in this condition.

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Literature study on autumn-dryness syndrome (추조(秋燥)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Han, Jae-Soo;Kwon, Hyuk-Sung;Lee, Joo-Hee;Jung, Sung-Ki;Lee, Hyung-Goo
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.321-333
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    • 1994
  • 1. Autum-dryness syndrome(秋燥) is caused by dry-warm or dry=-cool weather condition when lower-warmer Eumfen(下焦陰分) was injured by jung hyoul hatal(精血下脫) or taking medicines of dryness in autumn. 2. The symptoms of autum-dryness syndrome are headach, fever, chilling, anhydrosis, dry cough, tinnitis, dry lip, dry skin, chest discomfort in cool-dryness syndrome(凉燥) and headach, fever, dry cough, paroxymal cough, dry skin, chest pain, polydipsia, tinnitis, eye redness, sore throat in heat-dryness syndrome(溫燥). 3. Hyangsochongsitang(香蘇蔥頭湯) chn be applied for terating cool-dryness syndrome(凉燥) and chungjogoopyetang(淸燥救肺湯) for heat-dryness syndrome(溫燥). Sang Hang Tang(桑杏湯) can be administered when the evils located in the upper-warmer, and Yukmihwan(六味丸) can be administered when located in the lower-warmer(下焦) 4. According the determination of treatment based on the differentiation of symptoms and signs. When the symptoms of Weifen syndrome(衛分證) are headach, fever, dry lip or chilling or dypsia and the treatment of weifen syndrome apply Hangsosan(行蘇散) or Sang hang tang(桑杏湯). When the symptoms of Qifen syndrome(氣分證) are tinnitis, eye redness, sore throat, chest discomfort, polydipsia, dry cough, watery diarrhea, constipation and Jibaekjihwang(知栢地黃丸) when Ohingulpitang(五仁橘皮湯) Chungjogupyetang(淸燥救肺湯) can are applied for treating Qifen syndrome(氣分證). When the symptoms of younghylfen syndrome(營血分證) are dry cough, watery diarrhea, dypsia, chest discomfort, hematemesis, epistaxis and agyohwang keum tang(阿膠湯) Oknyujun(玉女煎) can be applied for treating Younghyulfen syndrome(營血分證).

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Changes in Peak Expiratory Flow, Forced Expiratory Volume in 1 Second and Peak Cough Flow Related to Functional Level and Measurement Position in Patients With Duchenne Muscular Dystrophy (뒤시엔느 근 이영양증 환자에서 기능 수준과 측정 자세에 따른 최대호기유량, 1초간노력성호기량 및 최대기침유량의 변화)

  • Kim, Ki-Song;Cynn, Heon-Seock
    • Physical Therapy Korea
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    • v.16 no.3
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    • pp.1-8
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    • 2009
  • It is important to find the effective position for cough and sputum clearance in respiratory physical therapy. The purpose of this study was to compare the changes in peak expiratory flow (PEF), forced expiratory volume in 1 second ($FEV_1$), and peak cough flow (PCF) related to functional level and measurement position in patients with Duchenne muscular dystrophy. Twenty one subjects were classified into three functional levels, and measurements was undertaken in three different measurement positions (upright sitting, $45^{\circ}$ reclining and supine). Vitalograph PEF/FEV DIARY was used to measure PEF and $FEV_1$, and Ferraris Pocket Peak was used to measure PCF. Mixed two-way analysis of variance and Bonferroni post-hoc test were used for statistical analysis. The results of the study were as follows: 1) Significant main effects for measurement position were found. 2) PEF was the highest in upright sitting, followed by $45^{\circ}$ reclining, and supine in order. 3) $FEV_1$ in upright sitting and $45^{\circ}$ reclining were significantly greater compared with that in supine. 4) PCF in upright sitting and $45^{\circ}$ reclining were significantly greater compared with that in supine. 5) No significant main effects for functional level were found in PEF, $FEV_1$, and PCF. 6) No significant functional level by measurement position interactions were found in PEF, $FEV_1$, and PCF. Therefore, it is concluded that upright sitting and $45^{\circ}$ degree reclining positions are recommended for effective cough and sputum clearance.

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An Analysis of Clinical Characteristics of Patients with Cough by Food-accumulation and Yin-Deficiency (식적(食積) 및 음허(陰虛)로 인한 해수 환자의 임상적 특성 분석)

  • Lee, Jung-Wook;Park, Sang-Moo;Kang, Baek-Gyu;Han, Deok-Jin;Na, Ran-Hee;Bang, Chang-Ho;Jang, Seak-Oh;Son, Ji-Woo;Lee, Si-Hyeong
    • The Journal of Internal Korean Medicine
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    • v.30 no.1
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    • pp.85-93
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    • 2009
  • Cough is a common clinical problem to which various etiologies are attributable. In Korean medicine there are differentiations in etiology such as food-accumulation and Yin-deficiency. This study was aimed to analyze the relations between the time of cough and Korean syndrome differentiations and to compare the symptoms of Korean syndrome differentiations (food-accumulation and Yin-deficiency). Sixty-two cough patients were analyzed and classified into one of two syndrome differentiations by etiology. We compared the time of coughing and symptomatic characteristics of two: such as symptom differences and change of severity after treatment. Patients with food-accumulation were more prevalent than patients with Yin-deficiency. Among symptoms, anorexia, dyspepsia, nausea and nasal discharge were more prevalent in food-accumulation while pruritus of throat was prevalent in Yin-deficiency. Coughing at night was prevalent in Yin-deficiency and coughing at rising hour was prevalent in food-accumulation.

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A Case Report of Patient Suffering from Cough and Dyspnea after Lung Transplantation Treated with Complex Korean Medicine (기침 및 호흡곤란을 호소하는 폐 이식 환자의 복합 한방 치험 1례)

  • Seyeon Lee;Kibeom Ku;Mariah Kim;Irang Nam;Minhwa Kim;Changwoo Han;In Lee;Jinwoo Hong;Jungnam Kwon;Soyeon Kim;Youngju Yun;Sojung Park;Junyong Choi
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1101-1108
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    • 2023
  • We report the case of a lung transplantation patient whose cough and dyspnea symptoms improved after receiving complex Korean medicine treatment. Lung transplantation provides a solution to many end-stage patients with lung disease who are refractory to conventional treatment, but the five-year survival rate of lung transplantation remains around 50%, and even surviving patients suffer from side effects, including infection, respiratory difficulty, and gastrointestinal problems. A 66-year-old woman with rheumatoid arthritis-interstitial lung disease was advised to undergo lung transplantation surgery when she suffered from dyspnea and failing respiratory symptoms after being diagnosed with COVID-19 and contracting pneumonia. Approximately five months after receiving a bilateral lung transplantation operation, she experienced acute pulmonary thromboembolism, and even after receiving anticoagulation therapy, she still struggled with cough and respiratory difficulty. After she received complex Korean medicine treatments, including herbal medicine, cupping therapy, and electrical moxibustion, we observed a decrease in inflammation, alleviation of symptoms such as cough and dyspnea, and improvement of pulmonary function and exercise capacity.

The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

The Clinical Significance of Serum CD23 and CD25 in Chronic Cough Patients (만성 기침환자에서 혈청 CD23와 CD25 측정의 임상적 의의)

  • Choi, Jae-Chol;Park, Young-Bum;Jee, Hyun-Suk;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.471-477
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    • 2000
  • Background : Coughing is the most common complaint for which patients seek medical service. When caughing continues over 3 weeks in non-smokers who do not take cough-provoking drugs, they are classified as patients with chronic cough. Three well known main causes of chronic caugh are postnasal drip syndrome, bronchial asthma and gastroesophaseal reflux disease. Among them, postnasal drip syndrome is reported to be the most common cause of all in chronic cough diseases, and allergic inflammation plays an important role in the pathogenesis of postnasal drip syndrome. CD23 and CD25 which are low affinity receptor for IgE and IL-2 receptor alpha, respectively, are closely related to allergic inflammation and their roles were evaluated in chronic cough patients. Methods : We evaluated 105 patients with chronic cough and selected 56 patients for measurement of serum CD23 & CD25 levels. We selected 10 normal, medical students for comparison of serum CD23 & CD25 levels. Result : The postnasal drip syndrome was found to be the most common cause of chronic cough. Serum CD23 and CD25 did not increase in chronic cough patient compared to normal controls. However in bronchial asthma patient, serum CD23 level was increased relative to normal control (p<0.05). Conclusion : In bronchial asthma presented as chronic cough, lymphocyte mediated allergic inflammation may related with the pathogenesis of the disease.

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