• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.372-375
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• 2000

Spinal epidural emphysema is rare, and only a few cases have ever been reported. A 18 year-old man was admitted for neck and chest pain for 3 days. Before admission he experienced rhinorrhea and severe cough. Physical examination revealed wheezing on whole lung field and subcutaneous emphysema over the upper portion of the chest and neck. Chest radiograph showed pneumomediastinum and subcutaneous emphysema in the neck and chest CT images demonstrate a free air in the prevertebral fascia. With conservative management, the patient's condition and the pneumomediastinum improved. The patient was discharged to home on the fourteenth day.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.616-621
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• 1993

Leiomyoma of the trachea is a very rare tumor, and the tracheal tumor is frequently misdiagnosed and treated as bronchial asthma. We report here a case of leiomyoma of the trachea which was successfully resected. A 40-year-old woman has sufferred from a repeated episode of asthmatic attack for two years. Intensive therapy for asthma had no beneficial effect on her respiratory symptoms, and wheezing and stridor did not disappear. Chest CT and bronchoscopy revealed a pedunculated mass on the trachea just above the carina. Wedge resection of the trachea and right main stem bronchus including the tumor and end-to-end anastomosis was performed. The result of the pathologic examination of the tumor was tracheal leiomyoma. Her postoperative course was uneventful and postoperative bronchoscopic findings showed clear healing of the anastomosis site.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.449-454
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• 1996

Functional upper airway obstruction due to vocal cord dysfunction is being increasingly recognized and has been variously described as "Munchausen's stridor", "Emotional laryngeal wheezing", "Nervous asthma". It's features are symptoms of acute reversible recurrent dyspnea associated with an inspiratory stridor, normal anatomy of the upper airway, demonstration of variable severe exthrathoracic upper airways obstruction with pathologic adduction of the vocal cord at bronchoscopy. The patients with this condition are frequently misdiagnosed as asthma and the diagnosis is often delayed. So they can present a serious medical problem and are exposed to the complication of treatment and investigation. We report a case of functional upper airway obstruction due to vocal cord dysfunction who showed paradoxical vocal cord motion at bronchoscopy and typical features of variable exthrathoracic obstruction on Flow-volume loop during a symptomatic period.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.1-6
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• 2008

Previous infant feeding guidelines recommended a delayed introduction of solids to beyond 6 months of age to prevent atopic diseases. However, scientific evidence supporting a delayed introduction of solids for prevention of atopic diseases is scarce and inconsistent. Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation in the prevention of atopic disease. In studies of infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein decreases the incidence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. For infants at high risk of developing atopic disease who are not breastfed exclusively for 4 to 6 months, there is modest evidence that atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cow milk formula, in early childhood. There is no convincing evidence that a delayed introduction of solid foods beyond 4 to 6 months of age prevents the development of atopic disease. For infants after 4 to 6 months of age, there are insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.

• The Journal of Internal Korean Medicine
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• v.37 no.3
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• pp.484-494
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• 2016

Objective: This study was designed to analyze the treatment effects of Chungsangboha-tang through retrospective chart reviews.Methods: Fifty-one outpatients who had visited the Allergy, Immune & Respiratory System Division at the Kyung Hee Korean Medicine Hospital and who had taken Chungsangboha-tang from February 1, 2006, to February 1, 2016, had their basic medical records and examinationsretrospectively reviewed with respect to IgE, eosinophil, AST, and ALT. The PFT results of 11 patients were also investigated with respect to FEV1, FVC, and FEV1/FVC.Results: The percentage of males and females was 49.02% and 50.98%, respectively. The past histories of patients included asthma (66.67%), unspecified cough (21.57%), COPD (9.80%), allergic rhinitis (7.84%), and others. The subjective symptoms included cough (82.35%), sputum (39.22%), dyspnea (37.25%), and others. The most numerous pattern identification was wheezing dyspnea. IgE was significantly reduced, and eosinophil had a reduced tendency after 116.76±160.40 days of taking Chungsangboha-tang. PFT results also significantly increased after 213.09±266.62 days, while AST and ALT results showed a reduced tendency. In the asthmatic group, IgE also showed a reduced tendency. In particular, IgE was significantly reduced in patient groups taking medicine for more than 12 weeks.Conclusions: The conditions of patients with chronic pulmonary disease such as asthma and COPD significantly improved with Chungsangboha-tang after more than 12 weeks.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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• pp.394-406
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• 2006

Backgrounds and Objectives: Asthma is considered to be an inflammatory disease characterized by airway hyperresponsiveness and Pulmonary eosinophilia. And it is known the structure and function of IL-5, its receptor and the mechnism IL-5 triggered eosinophil accumulation and inflammaion of the airways. At this point of view, we assume which oriental materia medics can the splenocyte inhibit from secreting the IL-S in vitro. Material and Methosds: We used the splenocyte of mouse 8 weeks after its birth, and then cnltivated those into the 2 experimental groups and control group for 48 hours. The culture medium of experimental groups were made of $1{\mu}g/ml,\;10{\mu}g/ml$, oriental materia medics, representative. And the culture media of control group was given no oriental materia medica. Then, we assayed the quantity of cytokine-expression by the Sandwich ELISA. The quantifies of cytokine-expression of the experimental groups were compared with that of the control group which was standardized These method were used for the all of oriental materia medica treated. Results: In this study, we demonstrated that 12 oriental materia medica that inhibit the splenocyte from secreting the IL-5 in both $1{\mu}g/ml,\;and\;10{\mu}g/ml$ culture media. Those were Equiseti Herbs, Sophorae Subprostratae Radix, Moutan Radicis Cortex. Trichosanthis Radix, Buddleiae Flos. Cyperi Rhizoma. Benincasae Semen, Armeniacae Semen. Zedoariae Rhizoma, Astragali Semen, Dolichoris Semen. Lilii Bulbus, Asparagi Radix, Atractylodes Rhizoma White, Polygonati Officinallis Rhizoma. Conculusions: These findinga indicate that some oriental materia medica, specially Antipyretics, Herbs for Resolving Phlegm, Relieving Cough and Calming Wheezing and Herbs for Tonifring and Invigorating effects inhibit the splenocyte from secreting the IL-5. And further study experimented in vivo is needed for treating IL-5-driven inflammatory disease including asthma.

• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.274-285
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• 1994

The effects of resin on the respiratory health have been investigated in 309 workers from four iron and steel foundries and the results compared with those from 122 workers who were not significantly exposed to resin gas and silica dust at the same industries. Phenol-formaldehyde resin was used in the core making and molding processes and workers were exposed to their decomposition products as well as to silica dust containing particulates. The subjects were grouped according to formaldehyde, dust and other gas exposures, and smoking habits were considered also in thi analysis. Standardized respiratory symptom questionnaire was administered by trained interviewers. Chest radiograph, pulmonary funtion tests, and methacholine challenge tests were done. Environmental measurements at the breathing zone were carried out to determine levels of formaldehyde, respiable dust and total dust. Foundry workers had a higher prevalence of symptoms of chronic bronchitis with chronic phlegm and chronic cough when exposed to dust. Exposure to gas was significantly associated with lowered $FEV_1$ and obstructive pulmonary function changes. Exposure to formaldehyde and phenol gas was associated with wheezing symptom among workers, but $FEV_1$ changes after methacholine challenge were not significantly different among different exposure groups. When asthma was defined as the presence of bronchial hyperreactivity with more than 20% decrease in $FEV_1$ after methacholine challenge, 17 workers out of 222 tested had asthma. Fewer asthmatic welters were found among groups exposed to formaldehyde, gas and dust, which indicates a healthy worker effects ill a cross-sectional study. The concentration of formaldehyde gas ranged from 0.24 to 0.43 ppm among studied foundries. The authors conclude that formaldehyde and phenol gas from combusted resin is probably the cause of asthmatic symptoms and also a selection force of those with higher bronchial reactivity away from exposures.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.559-573
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• 1997

Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

• Tuberculosis and Respiratory Diseases
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• v.67 no.4
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• pp.311-317
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• 2009

Background: The methacholine bronchial provocation test is a useful tool for evaluating asthma in patients with normal or near normal baseline lung function. However, the sensitivity of this test is 82~92% at most. The purpose of this study is to evaluate the clinical usefulness of $FEF_{25-75%}$ in identification of airway hyperresponsiveness in patients with suspected asthmatic symptoms. Methods: One hundred twenty-five patients who experienced cough and wheezing within one week prior to their visiting the clinic were enrolled. Results: Sixty-four subjects showed no significant reduction of $FEV_{1}$ or $FEF_{25-75%}$ on the methacholine bronchial provocation test (Group I). In 24 patients, $FEF_{25-75%}$ fell more than 20% from baseline without a 20% fall of $FEV_{1}$ during methacholine challenge (Group II). All patients who had more than 20% fall of $FEV_{1}$ (n=37) also showed more than 20% of reduction in $FEF_{25-75%}$ (Group III). Baseline $FEV_{1}$/FVC (%) and $FEF_{25-75%}$ (L) were higher in group II than group III (81.51${\pm}$1.56% vs. 75.02${\pm}$1.60%, p<0.001, 3.25${\pm}$0.21 L vs. 2.45${\pm}$0.21 L, p=0.013, respectively). Group II had greater reductions of both $FEV_{1}$ and $FEF_{25-75%}$ than group I at 25 mg/mL of methacholine (p<0.001). The provocative concentration of methacholine causing a 20% fall in $FEF_{25-75%}$ in group II was about three-fold higher than that in group III. Conclusion: A 20% fall of $FEF_{25-75%}$ by methacholine provocation can be more sensitive indicator for detecting a milder form of airway hyperresponsiveness than $FEV_{1}$ criteria.

• Journal of Preventive Medicine and Public Health
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• v.43 no.5
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• pp.369-376
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• 2010

Objectives: The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. Methods: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. Results: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). Conclusions: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.