• Title/Summary/Keyword: Wheezing asthma

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Effectiveness and safety of seasonal influenza vaccination in children with underlying respiratory diseases and allergy

  • Kang, Jin-Han
    • Clinical and Experimental Pediatrics
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    • v.57 no.4
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    • pp.164-170
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    • 2014
  • Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

Clinical Study of Quality-of-Life in Asthmatic Patients managed by Oriental Medical Treatments (한방치료에 따른 천식환자의 삶의 질에 대한 임상적 평가)

  • Ju, Chang-Yeop;Heo, Tae-Seok;Jung, Hee-Jae;Jung, Sung-Ki;Rhee, Hyung-Koo;Han, Dong-Ha
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.575-581
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    • 2000
  • Objective : Asthma is a lung disorder characterized by periodic attacks of wheezing alternating with periods of relatively normal breathing. And quality of life in asthmatic patients shows a tendency to decrease. So we had a clinical study whether if oriental medical treatment could improve their quality of life or not. Methods : The 15 cases were new patients that visited at division of respiratory system, department of internal medicine in Kyunghee medical center from the 1 st of July, 2000 to the 1 st of August. All of them were diagnosed as asthma and treated by western medical therapy. We used a Quality of Life Questionnaire for adult Korean Asthmatics(QLQAKA) and evaluated the results after two times answers, at an interval of two weeks. Results : The mean of the first answer was 2.84 marks and 3.36 ones after two weeks. If there is a difference of over 0.5 points between the two, we can admit significant effect. After the asthmatic patients treated by oriental medical therapy, they gained a difference of 0.52 points, 10.4%. Conclusions : We suggest that oriental medical therapy can improve the quality of life of asthmatic patients arid we can alternate side effects of western medical therapy with oriental one. if they carry out two different treatments at the same time.

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Reliability and Validity of the Korean Version of ISAAC Questionnaire (한국판 국제 소아천식 및 알레르기 질환 연구 설문지의 신뢰도 및 타당도 연구)

  • Choi, Seong-Woo;Ju, Yeong-Su;Kim, Dae-Sung;Kim, Jae-Yong;Kwon, Ho-Jang;Kang, Dae-Hee;Lee, Sang-Il;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.361-371
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    • 1998
  • Recent increases of asthma and allergies in childhood made the need for a standardized approach to international and regional comparisons of their prevalence and severity. To address these issues, 'International Study of Asthma and Allergies in Childhood (ISAAC)' is currently underway. In Korea, 'Nationwide Study of Asthma and Allergies in Korean Children' began in 1995 according to ISAAC protocol. ISAAC written and video questionnaires were used in this survey, but their reliability and validity were not evaluated properly yet. In this study, our aim was to evaluate the reliability and validity of two kinds of questionnaires and their usefulness in international and regional comparisons. The test and retest of two questionniares were completed by male(n=110) and female(n=111) middle school students with two and three weeks interval each. Kappa(or weighted kappa) were calculated from each questions and validity coefficients were estimated from those statistics. In Korean version of written questionnaire, the questions for allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and food allergy proved to have high kappa values (or weighted kappa values) and validity coefficients and they can be used in further studies without any correction. But some questions about asthma(especially nocturnal cough, wheezing in exercise, and severe asthma) and drug allergy need to be revised for better under-standing to study subjects. Video questionnaire has the same degree of reliability and validity when compared to written questionnaire and this is the unexpected result. Accordingly, it also need to be revised to overcome the racial and cultural differences of the study subjects. In conclusion, the Korean version of written and video questionnaires may be considered to be useful methods in international and regional comparisons of asthma and allergic diseases in childhood after correction of some questions.

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The clinical study of chronic obstructive pulmonary disease (만성폐쇄성폐질환환자 1례에 대한 임상적 고찰)

  • Kim, Joo-Sung;Lim, Seong-Woo;Son, Jeong-Suk
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.525-528
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    • 2000
  • We report the treatment case of patient for chronic obstructive pulmonary disease. The patient was 65 year-old woman with the history of smoking and asthma. She had complained of dyspnea, hyperpnea, cough and wheezing sound. We treated her with general management, bronchodilator and five kinds of herbal medicine(Samjahwadamjeon etc). Among them, the major herbal medicine is Samjahwadamjeon. Having been treated for 35 days, the patient improved in clinical symptoms and pulmonary function in PFT(Pulmonary function test).

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Clinical Evaluation of 3 patients with Paradoxical Vocal Cord Movement (역설적 성대운동을 보이는 3명의 환자에 대한 임상분석)

  • 최선명;임길채;한광우;남순열
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.83-86
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    • 2003
  • Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

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A Case of Dyspnea due to Double Aortic Arch (이중대동맥궁으로 인한 호흡곤란 1례)

  • 최용식;김덕준;손영탁;송달원
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.159-163
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    • 1995
  • Double aortic arch is the most common among vascular structure anomalies in infancy. It's clinical manifestations vary from incidental discovery without symptoms to symptoms of tracheal or esophageal compression such as stridor, wheezing, excessive secretion, dyspnea and dysphagia. Characteristically many patients show little sign of respiratory difficulty during sleep and quiet monents but this symptom is frequently exacerbated by crying or exertion, which may be difficult to distinguish from bronchial asthma. CT and MRI are believed to be the most valuable methods of diagnosis and surgical intervention is necessary in severe cases. Recently, we experienced a case of dyspnea due to double aortic arch. So we report this case with review of literatures.

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Foreign bodies in air passage in Children (소아의 기도이물에 관한 통계적 관찰)

  • 유장열;오경균;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.8.5-9
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    • 1977
  • Foreign bodies in food and air passage, especially the latter in infants and children requires emergency treatment. The frequent symptoms are coughing, wheezing, and dyspnea, So may be confused as asthma, pneumonia and acute Laryngitis. The species and incidence of the foregin bodies are variable according to the age, method of life, environment and economic condition. The authors experienced 35 cases of foreign body in air passage during the period of last 3yrs which were treated by ventilating Bronchoscopy, and thoractomy in this hospital. One of them was lead to death. The authors analysed above cases and report with it's literature consideration. Results: 1. The prevalent foreign bodies were peanut, metal, food particles in order of frequency. 2. In frequent symptoms were dyspnea, coughing and wheezing in the order. 3. In the age incidence, 48% of the foreign bodies were 1∼5yrs. 4. In sex distribution, male to female ratio was 2.1: 1 5. In duration of lodgment, 65% of the foreign body were removed within 24hrs. 6. Most prevalent site of the foreign body was Rt. main bronchus Rt. to Lt. ratis was 2 : 1 was 7. Treatment was done; 25 cases were by ventilating bronchoscopy.

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Clinical Analysis of Suspected Airway Foreign Bodies in Infants and Children (의증 유소아 기도이물의 임상적 고찰)

  • 안병훈;송달원;최용식;박기철;이근양;김중강
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.84-93
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    • 1997
  • The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

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Pulmonary Function and Its Influence Factors of Residents in Yeosu Industrial Complex

  • Hong, Eun-Ju;Ahn, Gi-Sub;Chung, Eun-Kyung;Guo, Xinbiao;Son, Bu-Soon
    • Journal of Environmental Science International
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    • v.20 no.7
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    • pp.799-809
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    • 2011
  • Objectives: This study is aimed at identifying the influential factors on the pulmonary function of ordinary residents in the surrounding areas of Yeosu Industrial Complex. Methods: The PFT (Pulmonary Function Test) was conducted on the target residents numbering 989 people (male 361, female 628). The exposed group (813 people) resided within the radius of 5km from Yeosu Industrial Complex and the control group (176 people) resided in the radius of more than 15 km from May 2007 to November 2007. The survey also took into account other factors including personal characteristics, life habits, respiratory diseases and allergic symptoms, medical histories, and the living environments of the residents in order to further identify influential factors on pulmonary function. Result: When comparing the PFT values of the exposure groups to the control group of the same city, values of the exposure groups were meaningfully lower with an %$FEV_1$ of 107.05% and %FVC of 100.28%. Conversely, the control group reported an %$FEV_1$ and %FVC of 107.26% and 102.85% respectively, indicating that ambient air pollutants reduce lung function. The odds ratio of asthma diagnosis history increased when a subjects residence was close to a heavily trafficked road, traffic amount was huge, a bed was used, and the family had less than four members. However the results were not statistically meaningful. The odds ratios of abnormal pulmonary function were statistically higher among those with asthma(OR=4.29, CI=1.75-10.56), wheezing (OR=2.59, CI=1.24-5.41), and nasal congestion (OR=2.87, CI=1.36-6.08) (p<0.01). The factors affecting $FEV_1$ were symptoms including asthma, passive smoking and allergic eye disease ($R^2$=0.049, p<0.001). For the FVC symptoms including asthma ($R^2$=0.014, p<0.001) were measured. The analysis showed that FVC decreased with increases in $O_3$ and CO(p<0.01). Furthermore, $FEV_1$ decreased with increases in $O_3$(p<0.01). Conclusions: These results will provide preliminary data for establishing responsive measures to protect the health of residents in industrial complexes from air pollution, and to develop lasting environmental health policies.

The Relationship Between Allergic Responses and Oxidative Stress Among Male Adults in an Industrial Area (일부공단지역에 거주하는 성인남성의 알레르기 반응과 산화손상에 대한 연구)

  • Ki, Young-Sun;Min, Jin-Young;Yoo, Hong-Sik;Paek, Do-Myung
    • Journal of Environmental Health Sciences
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    • v.34 no.2
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    • pp.117-123
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    • 2008
  • Allergic diseases have been dramarically increased over recent years, especially in industrialized countries. Oxidative stress has been believed to playa significant role in the occurrence of the allergic inflammatory responses. Although previous studies concerning oxidative stress and systemic inflammation have been reported, few data is available, and other allergic diseases, except for asthma, are hardly studied about the association with oxidative stress. This study evaluated the relationship between allergic disease and Malondialdehyde (MDA) as an indicator of oxidative stress. The study population was 197 male adults living in an industrial area. The ISAAC questionnaire was used to confirm wheezing and rhinitis, and atopy was evaluated by skin prick test. MDA was analyzed by spectrophotometer. To examine bronchial hyperresponsiveness (BHR), methacholine test was performed, and the index of bronchial responsiveness (BR index) was calculated. We used multivariate logistic regression model and general linear model with SAS program. We found significant associations of MDA with brindex (p=0.023), rhinitis (p=0.016), atopy (p=0.03), adjusted by age, smoking, and body mass index (BMI). On the contrary, there was no significant difference of MDA with the status of asthma. Our result suggests that oxidative stress may playa major role in the occurrence of allergic response in male adults.