• Title/Summary/Keyword: Disease Exacerbation

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Drug-Induced Bullous Pemphigoid Associated with the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 Vaccine: Case Report

  • Hyun-Jeong Park;Ji Hoo Kim;Jong-Mo Ahn;Ji-Won Ryu
    • Journal of Oral Medicine and Pain
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    • v.48 no.3
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    • pp.118-122
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    • 2023
  • In this study, we investigate the emergence of bullous pemphigoid (BP) after the administration of the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 (SARSCOVID-19) vaccine. The study presents two cases of women, aged 47 and 53, diagnosed with BP following SARS-COVID-19 vaccination. BP is a common autoimmune blistering disorder prevalent among older populations, with an incidence rate ranging from 2 to 40 cases per million individuals. This condition arises when autoantibodies target adhesive proteins in the skin, resulting in blister formation and mucosal erosion. Drug-induced bullous pemphigoid (DIBP) shares similarities with the classic form of BP but may be influenced by medication usage. Notably, DIBP exhibits distinct characteristics, such as affecting a younger demographic and involving mucosal regions more prominently than classic BP. The growing incidence of BP is linked to factors such as an aging population and the rise of drug-induced cases. This case report provides valuable insights into comprehending DIBP, elucidating post-vaccination discomforts, particularly those related to oral lesions and the exacerbation of existing lesions. By elucidating these aspects, we aim to advance the understanding of DIBP within the medical community.

Experiences of Medication Misuse and Abuse Behaviors in Elderly People with Chronic Disease in Community (지역사회에 거주하는 만성질환 노인의 약물 오·남용행위 경험)

  • Kim, Jeong Sun
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.791-805
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    • 2016
  • The purpose of this study was to understand the essential meanings in experiences of medication misuse and abuse behavior in elderly people with chronic disease in community. The participants were 10 patients with chronic disease over 65 ages who were selected by convenience sampling. Data were collected through individual in-depth interviews from February to May 2014, and were analyzed using Colaizzi (1978)'s phenomenological analysis method. As a results, the essential meanings and structure of medication misuse and abuse behavior experience in elderly people with chronic disease were derived into five clusters of themes as follows: 'Burden on the medications', 'Anxiety about the side effect of the medications or the disease exacerbation', 'There is no alternative other than the medications', 'Expectations of the medications effect for my criteria', 'Lack of understanding on the correct medication use'. The results of this study contributed to promoting a deeper understanding of medication misuse and abuse behaviors in elderly people with chronic disease, and provided for the basic data of strategic development for the prevention of medication misuse and abuse behaviors from the perspective of elderly people with chronic disease in community.

Exhaled Nitric Oxide in Patients with Stable Chronic Obstructive Pulmonary Disease: Clinical Implications of the Use of Inhaled Corticosteroids

  • Jo, Yong Suk;Choe, Junsu;Shin, Sun Hye;Koo, Hyeon-Kyoung;Lee, Won-Yeon;Kim, Yu Il;Ra, Seung Won;Yoo, Kwang Ha;Jung, Ki Suck;Park, Hye Yun;Park, Yong-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.42-50
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    • 2020
  • Background: Fractional exhaled nitric oxide (FeNO) is regarded as a potential biomarker for identifying eosinophilic inflammation. We aimed to evaluate the clinical implication of FeNO and its influence on inhaled corticosteroids (ICS) prescription rate in Korean chronic obstructive pulmonary disease (COPD) patients. Methods: FeNO level and its association with clinical features were analyzed. Changes in the prescription rate of ICS before and after FeNO measurement were identified. Results: A total of 160 COPD patients were divided into increased (≥25 parts per billion [ppb], n=74) and normal (<25 ppb, n=86) FeNO groups according to the recommendations from the American Thoracic Society. Compared with the normal FeNO group, the adjusted odds ratio for having history of asthma without wheezing and with wheezing in the increased FeNO group were 2.96 (95% confidence interval [CI], 1.40-6.29) and 4.24 (95% CI, 1.37-13.08), respectively. Only 21 out of 74 patients (28.4%) with increased FeNO prescribed ICS-containing inhaler and 18 of 86 patients (20.9%) with normal FeNO were given ICS-containing inhaler. Previous exacerbation, asthma, and wheezing were the major factors to maintain ICS at normal FeNO level and not to initiate ICS at increased FeNO level. Conclusion: Increased FeNO was associated with the history of asthma irrespective of wheezing. However, FeNO seemed to play a subsidiary role in the use of ICS-containing inhalers in real-world clinics, which was determined with prior exacerbation and clinical features suggesting Th2 inflammation.

Correlation between Telomere Length and Chronic Obstructive Pulmonary Disease-Related Phenotypes: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort

  • Moon, Da Hye;Kim, Jeeyoung;Lim, Myoung Nam;Bak, So Hyen;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.3
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    • pp.188-199
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    • 2021
  • Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.

CHOP Deficiency Ameliorates ERK5 Inhibition-Mediated Exacerbation of Streptozotocin-Induced Hyperglycemia and Pancreatic β-Cell Apoptosis

  • Nam, Dae-Hwan;Han, Jung-Hwa;Lim, Jae Hyang;Park, Kwon Moo;Woo, Chang-Hoon
    • Molecules and Cells
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    • v.40 no.7
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    • pp.457-465
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    • 2017
  • Streptozotocin (STZ)-induced murine models of type 1 diabetes have been used to examine ER stress during pancreatic ${\beta}$-cell apoptosis, as this ER stress plays important roles in the pathogenesis and development of the disease. However, the mechanisms linking type 1 diabetes to the ER stress-modulating anti-diabetic signaling pathway remain to be addressed, though it was recently established that ERK5 (Extracellular-signal-regulated kinase 5) contributes to the pathogeneses of diabetic complications. This study was undertaken to explore the mechanism whereby ERK5 inhibition instigates pancreatic ${\beta}$-cell apoptosis via an ER stress-dependent signaling pathway. STZ-induced diabetic WT and CHOP deficient mice were i.p. injected every 2 days for 6 days under BIX02189 (a specific ERK5 inhibitor) treatment in order to evaluate the role of ERK5. Hyperglycemia was exacerbated by co-treating C57BL/6J mice with STZ and BIX02189 as compared with mice administered with STZ alone. In addition, immunoblotting data revealed that ERK5 inhibition activated the unfolded protein response pathway accompanying apoptotic events, such as, PARP-1 and caspase-3 cleavage. Interestingly, ERK5 inhibition-induced exacerbation of pancreatic ${\beta}$-cell apoptosis was inhibited in CHOP deficient mice. Moreover, transduction of adenovirus encoding an active mutant form of $MEK5{\alpha}$, an upstream kinase of ERK5, inhibited STZ-induced unfolded protein responses and ${\beta}$-cell apoptosis. These results suggest that ERK5 protects against STZ-induced pancreatic ${\beta}$-cell apoptosis and hyperglycemia by interrupting the ER stress-mediated apoptotic pathway.

Does the Use of Asthma-Controller Medication in Accordance with Guidelines Reduce the Incidence of Acute Exacerbations and Healthcare Costs?

  • Lee, Suh-Young;Kim, Kyungjoo;Park, Yong Bum;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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    • pp.11-17
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    • 2022
  • Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey

  • Chaeeun Kim;Haeun Lee;Kyunghee Jung-Choi;Hyesook Park
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.1
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    • pp.18-27
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    • 2024
  • Objectives: This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents. Methods: We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs). Results: Severe exacerbation of a family's economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status. Conclusions: The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.

Phylogeny, Morphology and Pathogenicity of Biscogniauxia mediterranea Causing Charcoal Canker Disease on Quercus brantii in Southern Iran

  • Samaneh, Ahmadi;Fariba, Ghaderi;Habiballah, Charehgani;Soraya, Karami;Dariush, Safaee
    • Research in Plant Disease
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    • v.28 no.4
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    • pp.209-220
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    • 2022
  • Charcoal canker of oak, which has recently increased in southern Iran, could pose a serious threat to the entire forest ecosystem in the near future. In addition, it seems that climate change and its consequences, such as drought in the southern regions of Iran, have exacerbated this phenomenon. Consequently, the objective of this study was to identify the fungal pathogens that could cause charcoal canker disease in the oak forests of South Zagros. It was also sought to find associations between changes in the occurrence/exacerbation of charcoal canker disease under non and intense drought stress in non-inoculated or inoculated Quercus brantii seedlings. In total, 120 isolates were obtained from eight oak forests located in the Zagros Mountains of Southern Iran, Kohgiluyeh & Boyer-Ahmad and Fars provinces, which were classified as Biscogniauxia mediterranea based on morphological assessment. Subsequently, molecular assay confirmed the result by phylogenetic inference of internal transcribed spacer-rDNA regions, α-actin, and β-tubulin genes. The results of the pathogenicity test showed that the response of isolates of B. mediterranea (Iran-G1 and Iran-M70) was varied in different environments for the measured necrotic lesion length. In comparison with the control moisture treatments (non-stress), the necrotic lesion length in inoculated treatments increased under intense drought stress. In general, inoculated oak seedlings' exposure to water-deficient stress by the pathogen of B. mediterranea could affect the spread/severity of the charcoal canker disease.

The relationship between body energy balance and problems of obesity and its effects on health (비만이 체내 대사에 미치는 영향)

  • 한정순
    • Journal of Applied Tourism Food and Beverage Management and Research
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    • v.10
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    • pp.219-238
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    • 1999
  • Obestity, characterized by an excess accumulation of fat, is a detriment to good health and wellbeing. It is easy for individuals to take on excess fat as soon as enough food and leisure are available in a society, causing an imbalance between energy intake and energy expenditure. Although there has been disagreement as to which side of this energy equation is more important in th epidemic of obesity, both sides are certainly involved. I think the prevalence of obesity begins with infancy. It seems to be relatively constant throughout childhood. Some retrospective studies have suggested that there is a direct progression from a fat chile to a fat adult. Obesity has been associated with excess mortality in many studies. The effect of obesity on cardiovascular disease has not always been an independent one, but has generally been through exacerbation of other rish factors such as hypertention, diabetes, hyperlipedmia, galbladder disease, gout and cancer of the grease and endometrium. The weights of identical twins raised in separate homes have been reported to be similar, thereby suggesting that heredity contributes significantly to weight. Overweight and obesity are by far greater health problems for many people in our society. Therefore in this paper we consider the relationship between body energy balance and problems of obesity. Whatever the weight of the person, the goal of the nutritionist and health care workers is to find solutions that will allow persons to feel better about themselves.

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Two Clinical Cases study of Atopic dermatitis on the Gynecology/Pediatrics department in oriental hospital of Semyung university (세명대 한방병원 부인/소아과에 내원한 아토피성 피부염환자의 임상치험 2례 고찰)

  • Kim, Hyeong-Jun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.2 s.33
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    • pp.247-255
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    • 2007
  • Objective : Atopic dermatitis is a chronic, inflammatory skin disease which was characterized by intense pruritus and the course marked by exacerbation and remission. The purpose of this study is to report the effect of oriental treatment. Especially new oriental prescription to atopic dermatitis Methods : We treated children patients who had atopic dermatitis and visited oriental hospital of Semyung University. Children patients in this case are two person. The first one is fourteen-years-old female, Other one is seven-years-old boy. And I create a new oriental prescription that named 'Allergy 1' thinking about oriental theory. After then I treated them with 'Allergy 1' herb medication and used two index to assess the severity in atopic dermatitis. Results : Each index show us approximately 70% improvement in atopic dermatitis symptom. Conclusion : On the basis of this cases, It may be considered that treatment of atopic dermatitis should be improved by the treatment of herb medication "Allergy 1"

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