Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.20
no.1
/
pp.63-67
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2009
Background and Objectives: In patients with asthma, increased obstruction and resistance of airway result in impairment in the generation of voice. Allergy and nasal polyposis, which are frequently observed in patients with asthma, are other factors that affect the vocal performance. Bronchodilators and steroids are commonly used in the treatment of asthma, and these agents also have been reported to be associated with voice changes. The aim of this study is to evaluate the voice quality in patients with mild to-moderate asthma by subjective and objective methods. Materials and Methods: A total of 36 patients with asthma established in the Department of Respiratory Medicine were included in this study. 23 were women and 13 were men, with a mean age of 51.7 years. The average duration of asthma was 77.0 months. All patients had mild-to moderate asthma. Acoustic and aerodynamic analyses were performed and the movements of the vocal cords were examined by videolaryngostroboscopy (VLS). Voice Handicap Index (VHI) and GRABS scales were used for subjective evaluations. Results: 50% of patients suffered from dysphonia and FO was 119.3${\pm}$23.7 Hz in male and 198.2${\pm}$18.4 Hz in female patients. There were no significant differences in average shimmer and NHR between females (4.90${\pm}$2.95% ; 0.1O${\pm}$0.04 dB) and males (4.64${\pm}$2.45% ; 0.20${\pm}$0.15 dB). However, the value of jitter was greater for females (2.60${\pm}$1.92%) than for males (1.21${\pm}$0.84%). The VHI score was above the normal limit in 35%, and VLS findings were shown diverse abnormality in 89% asthmatics from mucosal change to hyperfunction of supragottis and contact granuloma. But duration of illness and steroid dose did not correlate with these findings. Conclusion: Subjective and objective abnormality was shown in more than 50% of asthmatic patients. We suggest that persons who suffer from asthma should be examined for possible voice disorders by laryngologist. Additionally, appropriate medical care and voice therapy should be provided for those who have voice disorders associated with asthma.
Choi, Soo Han;Yoo, Keon Hee;Ahn, Kangmo;Sung, Ki Woong;Koo, Hong Hoe;Kim, Yae Jean
Pediatric Infection and Vaccine
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v.19
no.2
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pp.61-70
/
2012
Purpose: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. Methods: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. Results: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. Conclusion: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.
A clinical study of 106 cases of $Henoch-Sch{\ddot{o}}nlein$ purpura was made. The author analyzed the result of Korean traditional medical therapy. It was observed more frequently in female at the sex ratio of 1:1.3. The most prevalent age group was $4{\sim}9$ years(56.6%). In seasonal incidence, the cases were frequent during spring(50%), and the main specific history was upper respiratory tract infection(48.1%). The duration of contraction was $420.9{\pm}1079.3$ days. The adults were more chronic than children (p<0.05), The clinical manifestation showed in the skin (100%), the gastrointestinal tract(62.3%), the joints(64.2%), the kidney(25.3%), genitourinary system(11.3%), headache(6.6%), and scalp edema(4.7%) respectively. The first outbreak of symptoms was showing of skin purpura in 77 cases(72.6%) the highest frequency. and the gastrointestinal tract and joints were 16(15.1%) and 12 cases(11.3%) respectively. Of all patients, 22 cases(20.8%) experienced recurrences and 47 patients(44.3%) experienced hospitalization treatment. In the patients group which were recurrence experiences, the recurrence rate was high with patients(63.2%) who usually enjoyed meats and convenience foods and in patients(84%) who treated URI with chemical drugs(p<0.05). The patients group(68.9%) that took steroids also experienced a relatively high recurrence rate. Out of the patients(68.9%) who took treatment with steroids, 46.6% experienced side effects, in orders moon face(100%), weight gain(47.1%), appetite increase(52.9%), and acne. alopecia(11.8%), etc. There was a statistically significant relationship between the period of taking the steroid and the side effects(p<0.05), As the result of the herbal medicine treatment(treatment period: $6.7{\pm}6.2$ weeks, a follow-up survey during $15{\sim}24$ months), 67 patients(91.8%) among the 73 patients(68.9%) under 18 years old recovered completely but 3 cases(4.5%) recurred. 23 patients(69.7%) among the 33 patients(31.3%) above 19 years recovered completely but 5 cases(21.7%) recurred.
Kim, Tae-Hun;Lim, Cheong;Park, Il;Kim, Dong-Jin;Jung, Yo-Chun;Park, Kay-Hyun
Journal of Chest Surgery
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v.45
no.4
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pp.236-241
/
2012
Background: Prolonged usage of extracorporeal membrane oxygenation (ECMO) may induce multi-organ failure. This study is aimed to evaluate prognostic factors in the patients with ECMO. Also, the prognosis of ECMO with Kidney Injury Network Scoring system is studied. Materials and Methods: From May 2005 to July 2011, 172 cases of ECMO were performed. The cases of perioperative use of ECMO were excluded. Renal failure patient and younger than 15 years old one were also excluded. As a result, 26 cases were enrolled in this study. Male patients were 15 (57.7%), and mean age was $56.57{\pm}17.03$ years old. Demographic data, ECMO parameters, weaning from ECMO, and application of continuous renal replacement therapy are collected and Acute Kidney Injury Network (AKIN) scores were evaluated just before ECMO and day 1, day 2 during application of ECMO. Results: Venoarterial ECMO was applied in 22 cases (84.6%). The reasons for applications of ECMO were cardiac origin in 21 (80.8%), acute respiratory distress syndrome in 4, and septic shock in 1 case. Successful weaning from ECMO was achieved in 15 cases (57.7%), and survival discharge rate was 9 cases (34.6%). Mean duration of application of ECMO was $111.39{\pm}54.06$ hours. In univariate analysis, myocarditis was independent risk factors on weaning failure. Using the receiver operating characteristic curve, level of hemoglobin on 24 hours after ECMO, and base excess on 48 hours after ECMO were showed more than 0.7. AKIN score was not matched the prognosis of the patients with ECMO. Conclusion: In our study, the prognosis of the patients with myocarditis was poor. Hemoglobin level at first 24 hours, and degree of acidosis at 48 hours were useful methods in relating with prognosis of ECMO. AKIN scoring system was not related with the prognosis of the patients. Further study for prognosis and organ injury during application ECMO may be needed.
Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.
Purpose: Natural history and consequences of the novel 2009 influenza A H1N1(2009 H1N1) infection in immunocompromised pediatric patients are not yet fully understood. In this study, we investigated the clinical features and outcomes of the 2009 H1N1 infection in pediatric patients with hematological and oncological diseases. Methods: We retrospectively reviewed the medical records of 528 patients who had hematological and oncological diseases and who were treated at 7 referral centers located in the Yeungnam region. Among the 528 patients, 27 with definite diagnosis of 2009 H1N1 infection were the subjects of this study. All patients were divided into the following 3 groups: patients who were receiving chemotherapy (group 1), patients who were immunosuppressed due to a nonmalignant hematological disease (group 2), and patients who were off chemotherapy and had undergone their last chemotherapy course within 2 years from the influenza A pandemic (group 3). Results: All 28 episodes of 2009 H1N1 infection were treated with the antiviral agent oseltamivir ($Tamiflu^{(R)}$), and 20 episodes were treated after hospitalization. Group 1 patients had higher frequencies of lower respiratory tract infection and longer durations of fever and hospitalization as compared to those in group 2. Ultimately, all episodes resolved completely with no complications. Conclusion: These results suggest that early antiviral therapy did not influence the morbidity or mortality of pediatric patients with hematological and oncological diseases in the Yeungnam region of Korea after the 2009 H1N1 infection. However, no definite conclusions can be drawn because of the small sample size.
Kim, Ju-Sang;Kim, Sung-Kyung;Lee, Sang-Haak;Ahn, Joong-Hyun;Kim, Chi-Hong;Moon, Hwa-Sik
Sleep Medicine and Psychophysiology
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v.14
no.1
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pp.49-53
/
2007
Mitochondrial myopathy is characterized by variable clinical manifestations from mild limb weakness to fatal respiratory failure and central nervous system sequela. But it is a rare event that sleep disordered breathing become a clue of diagnosis for mitochondrial myopathy. We report a case of a 21 year-old man who was diagnosed as mitochondrial myopathy during the investigation for the possible cause of chronic hypoventilation syndrome. Before being admitted to our hospital, he was suspected as having sleep apnea syndrome in another hospital. We re-evaluated the history, physical examination, laboratoy findings and polysomnography in detail. Severe hypoxemia was noted during REM sleep on nocturnal polysomnography and the diagnosis of mitochondrial myopathy was made by muscle biopsy in rectus abdominis muscle. We treated him with bilevel positive airway pressure therapy during sleep and it could reverse the hypoxemia during REM sleep. He could be discharged with improved condition and is being well with the use of this ventilatory assistance.
Scatena, Roberto;Messana, Irene;Martorana, Giuseppe Ettore;Gozzo, Maria Luisa;Lippa, Silvio;Maccaglia, Alessandro;Bottoni, Patrizia;Vincenzoni, Federica;Nocca, Giuseppina;Castagnola, Massimo;Giardina, Bruno
BMB Reports
/
v.37
no.4
/
pp.454-459
/
2004
Experimental hyperoxia represents a suitable in vitro model to study some pathogenic mechanisms related to oxidative stress. Moreover, it allows the investigation of the molecular pathophysiology underlying oxygen therapy and toxicity. In this study, a modified experimental set up was adopted to accomplish a model of moderate hyperoxia (50% $O_2$, 96 h culture) to induce oxidative stress in the human leukemia cell line, U-937. Spectrophotometric measurements of mitochondrial respiratory enzyme activities, NMR spectroscopy of culture media, determination of antioxidant enzyme activities, and cell proliferation and differentiation assays were performed. The data showed that moderate hyperoxia in this myeloid cell line causes: i) intriguing alterations in the mitochondrial activities at the levels of succinate dehydrogenase and succinate-cytochrome c reductase; ii) induction of metabolic compensatory adaptations, with significant shift to glycolysis; iii) induction of different antioxidant enzyme activities; iv) significant cell growth inhibition and v) no significant apoptosis. This work will permit better characterization the mitochondrial damage induced by hyperoxia. In particular, the data showed a large increase in the succinate cytochrome c reductase activity, which could be a fundamental pathogenic mechanism at the basis of oxygen toxicity.
Endobronchial tuberculosis is frequently associated with lymphadenopathy, bronchial stenosis, atelectasis which needs to be differentiated with other pulmonary disease. Authors are presenting 25 cases of endobronchial tuberculosis which were confirmed by bronchoscopic biopsy and AFB smear and/or culture. The study was done on patients who visited Yeungnam University Hospital from May 1983 to July 1985. The following results were obtained: 1. Of the 25 cases, 8 cases were male and 17 cases were female (male : female= 1 : 2). 32 percent of the cases was older than 60 years of age. 2. Abnormal findings on chest x-ray were seen on 22 cases of 25 cases (88%) and its most predilective site was right upper lobe.(24%). 3. Symptoms were coughing (56%), hemoptysis, hoarseness, chest pain, dyspnea and fever in orders. 4. The positive results were obtained in 73 percent of sputum AFB sme ar (11 cases of 15 cases), 60 percent of AFB culture (3 cases of 5 cases) and 58 percent of bronchoscopic biopsy (14 cases of 24 cases). 5. Complete pulmonary function test was done on 19 cases and showed normal result in 6 cases, restrictive pattern in 8 cases and small airway dysfunction in 5 cases. No case of obstructive airway disease was detected. 6. Associated disease were hypertension (2 cases), tuberculous meningitis (1 case), diabetes mellitus (1 case), and cataract (1 case). 7. The site of bronchoscopic lesion on bronchoscopic examination were as follows; 8. All 25 patients were treated with anti-tuberculosis theyapy and 6 patients were treated with additional steroid therapy because of severe respiratory symptom and showed dramatic improvement of symptom as well as lung function.
Kauweloa, Kevin I.;Park, Justin C.;Sandhu, Ajay;Pawlicki, Todd;Song, Bongyong;Song, William Y.
Progress in Medical Physics
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v.24
no.4
/
pp.220-229
/
2013
Respiratory-induced dynamic tumors render free-breathing cone-beam computed tomography (FBCBCT) images with motion artifacts complicating the task of quantifying the internal target volume (ITV). The purpose of this paper is to study the visibility of the revealed ITV when the imaging dose parameters, such as the kVp and mAs, are varied. The $Trilogy^{TM}$ linear accelerator with an On-Board Imaging ($OBI^{TM}$) system was used to acquire low-imaging-dose-mode (LIDM: 110 kVp, 20 mA, 20 ms/frame) and high-imaging-dose-mode (HIDM: 125 kVp, 80 mA, 25 ms/frame) FBCBCT images of a 3-cm diameter sphere (density=0.855 $g/cm^3$) moving in accordance to various sinusoidal breathing patterns, each with an unique inhalation-to-exhalation (I/E) ratio, amplitude, and period. In terms of image ITV contrast, there was a small overall average change of the ITV contrast when going from HIDM to LIDM of $6.5{\pm}5.1%$ for all breathing patterns. As for the ITV visible volume measurements, there was an insignificant difference between the ITV of both the LIDM- and HIDM-FBCBCT images with an average difference of $0.5{\pm}0.5%$, for all cases, despite the large difference in the imaging dose (approximately five-fold difference of ~0.8 and 4 cGy/scan). That indicates that the ITV visibility is not very sensitive to changes in imaging dose. However, both of the FBCBCT consistently underestimated the true ITV dimensions by up to 34.8% irrespective of the imaging dose mode due to significant motion artifacts, and thus, this imaging technique is not adequate to accurately visualize the ITV for image guidance. Due to the insignificant impact of imaging dose on ITV visibility, a plausible, alternative strategy would be to acquire more X-ray projections at the LIDM setting to allow 4DCBCT imaging to better define the ITV, and at the same time, maintain a reasonable imaging dose, i.e., comparable to a single HIDM-FBCBCT scan.
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