• Title/Summary/Keyword: dyspnea

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Clinical characteristics of children and adolescents with croup and epiglottitis who visited 146 Emergency Departments in Korea

  • Lee, Doo Ri;Lee, Chang Hyu;Won, Youn Kyung;Suh, Dong In;Roh, Eui-Jung;Lee, Mi-Hee;Chung, Eun Hee
    • Clinical and Experimental Pediatrics
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    • v.58 no.10
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    • pp.380-385
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    • 2015
  • Purpose: Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients. Methods: The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged ${\leq}18years$ presenting with croup or epiglottitis. Results: We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were $2.2{\pm}2.0$ and $5.6{\pm}5.8years$, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05). Conclusion: Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

Two Cases of Acute Epiglottitis with Sitting up Position, Chin Thrust Forward, Having Dyspnea (특이한 이학적 소견을 보이는 급성 후두개염 2예)

  • Woo, Seung-Il;Koh, Young-Min;Ahn, Hye-Sook;Baik, Jae-Joong;Park, Keon-Uk;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.88-91
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    • 1996
  • Acute epiglottitis is a life threatening inflammatory. disease of the upper airway mainly in children, however, the recent reports about acute epiglottitis in adults are increasing. The common symptoms are sore throat, dysphagia, dyspnea and salivary drooling. As the laryngeal edema progresses, the patient sits up, leans forward, with the chin thrust forward, having obvious difficulty breathing. Early recognition and proper airway maintenance until the inflammatory edema subsides are essential steps to avoid a possible life threatening upper airway obstruction. We experienced two cases of acute epiglottitis with sitting up position, chin thrust forward, having dyspnea.

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Acute Respiratory Failure Accompanied with Eosinophilia (호산구 증가를 동반한 급성 호흡 부전증)

  • Um, Hyeon-Seok;Jang, Jie-Jung;Lee, Suk-Young;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Lee, Kyo-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.314-318
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    • 1993
  • Chronic eosinophilic pneumonia is an idiopathic condition characterized by chronic infiltration of the lung with eosinophils, weight loss, dyspnea, and pulmonary infiltration. Recently, we have experienced one case of chronic eosinophilic pneumonia presenting as the acute respiratory failure. A 34-year-old man was admitted to the hospital with one month's history of coughing, dyspnea, mucoid sputum, weight loss and one day's history of subcutaneous emphysema. The radiographic lung lesion and dyspnea rapidly progressed to a critical condition of acute respiratory failure. The combination of blood eosinophilia, lung infiltration on the chest x-ray, sign of acute rapiratory failure, rapid response to steroid therapy, and the finding of the transbronchial lung biopsy permit the diagnosis of chronic eosinophilic pneumonia.

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The Diagnostic Values of Ryodoraku and Pulse Analysis for a portion of Respiratory Disease (비체증(鼻涕證), 해수증(咳嗽證), 효천증(哮喘證) 환자(患者)에 대한 양도락(良導絡) . 맥진검사(脈診檢査)의 진단가치(診斷價値))

  • Shen, Feng-Yan;Lee, Sung-Hun;Jung, Hee-Jae;Jung, Sung-Ki
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.535-542
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    • 2008
  • Objectives : Ryodoraku, which is a physiological function test using electric current, is closely related to skin sympathetic tone. Pulse analysis is known to reflect cardiovascular reactivity. Refer to the previous researches Ryodoraku and pulse analysis have value as tools for diagnosing respiratory diseases. In this study we examined the diagnostic values of Ryodoraku and pulse analysis for respiratory disease patients. Methods : For this study. we conducted Ryodoraku and pulse analysis on 114 people, including 83 respiratory disease outpatients and 31 volunteers who did not have any respiratory symptoms or disease history. The respiratory patients were divided into three subgroups according to their symptoms: rhinorrhea group, cough-sputum group and wheezing-dyspnea group. Then we compared the disease groups with the control group. Results : When all experimental groups were compared with the control group, mean Ryodoraku was significantly lower. Mean H2, mean H3 and mean H6 were significantly lower in the rhinorrhea group (P<0.05), all the test results of Ryodoraku were evidently lower in the cough-sputum group (P<0.01), and most results of Ryodoraku were evidently lower in the wheezing-dyspnea group except H1 (P<0.01). Compared with the control group on pulse analysis, mean YP+/YP- was significantly lower in the wheezing-dyspnea group (P<0.05). Conclusion : Ryodoraku and pulse analysis were found to have a high value as quantitative diagnosis tools reflecting individuals' weakness and firmness. Nevertheless, more research is needed to find the further values.

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Clinical Study of Kamkil-tang on the Dyspnea (감길탕(甘桔湯)이 호흡곤란에 미치는 임상적 고찰)

  • Kim, Jin-Young;Ban, Hak-Jin;Park, Dong-Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1624-1630
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    • 2007
  • This study was designed to investigate the clinical effect of Kamkil-tang on the dyspnea. In this study, we measured the variations of the breathing volume of 20 patients after taking Kamkil-tang. Picrometer is used for the measurement of the volume. The investigation had been performed since from January 1st to August 31th of 2005. The patients for the experiment were mainly composed of patients who had trouble in breathing due to the pneumonectasis, asthmas, pneumonias. The percent of men is 65% in sex distribution and the ratio of persons over 50's was 90%. The results are as follows: After Kamkil-tang was taken to the patients, the enhancement ratio of breathing volume was appeared as 6.6%. The analysis based on an age was that the patients of 50's show the highest volumetric advancement. The ratio of breathing volume was higher as the patients were younger. From this, Kamkil-tang has more efficient on the younger patients. From the relations between the breathing volume before treatment and the enhancement ratio, the increase of the enhancement ratio and the better response to the medicine were shown to the more serious patients. The period of treatment was 22.4 days average. The enhancement ratio of smoker was 25.5, and that of non-smoker was 31.1. At the test of relation between the trouble rate in breathing and the enhancement ratio, Grade I shows the highest enhancement. From the experimental results, It is found that Kamkil-tang gives a noticeable benefit for the patients whose main symptom was breathing problem. Long-term treatments for the serious and younger patients will make much more efficient to the reduction of the symptoms.

Comparison of Multiple Chronic Obstructive Pulmonary Disease (COPD) Indices in Chinese COPD Patients

  • Zhang, Jinsong;Miller, Anastasia;Li, Yongxia;Lan, Qinqin;Zhang, Ning;Chai, Yanling;Hai, Bing
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.116-122
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    • 2018
  • Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

A simple statistical model for determining the admission or discharge of dyspnea patients (호흡곤란 환자의 입퇴원 결정을 위한 간편 통계모형)

  • Park, Cheol-Yong;Kim, Tae-Yoon;Kwon, O-Jin;Park, Hyoung-Seob
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.2
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    • pp.279-289
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    • 2010
  • In this study, we propose a simple statistical model for determining the admission or discharge of 668 patients with a chief complaint of dyspnea. For this, we use 11 explanatory variables which are chosen to be important by clinical experts among 55 variables. As a modification process, we determine the discharge interval of each variable by the kernel density functions of the admitted and discharged patients. We then choose the optimal model for determining the discharge of patients based on the number of explanatory variables belonging to the corresponding discharge intervals. Since the numbers of the admitted and discharged patients are not balanced, we use, as the criteria for selecting the optimal model, the arithmetic mean of sensitivity and specificity and the harmonic mean of sensitivity and precision. The selected optimal model predicts the discharge if 7 or more explanatory variables belong to the corresponding discharge intervals.

A Case of Formation of Interbronchial Fistula Complicated by Long-standing Bronchial Foreign Body (장기간 체류한 기관지내 이물에 합병된 기관지간 누공 형성 1예)

  • Lee, Jong-Hyun;Kim, Sung-Jun;Lee, Duk-Young;Chou, Jong-Dae;Jung, Su-Lyong;Na, In-Kyun;Kim, Dong-Wook;Lee, Jin-Kwan
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.882-887
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    • 1998
  • In healthy adults, diagnosis of aspiration of foreign body into tracheobronchial tree is not difficult because various symptoms such as dyspnea, coughing, or cyanosis develop when foreign body is aspirated into tracheobronchial tree. But unless a clear history of an aspiration event can be obtained, diagnosis will be delayed. Early complications of tracheobronchial foreign body aspiration include asphyxia, cardiac arrest, dyspnea, laryngeal edema, and cyanosis. Late complications include pneumonia, lung abscess, bronchiectasis, hemoptysis, bronchial stenosis, and polyp. Treatment is removal of foreign body by operation or bronchoscopy. Currently, flexible bronchoscopy is preferred in adults than rigid bronchoscopy. A 36-year-old male visited to Dongkang hospital due to productive coughing and dyspnea. On auscultation, focal inspiratory wheezing was heard. On chest PA, mild emphysematous change was seen Flexible bronchoscopy was done. Bronchoscopically, mucoid impaction, surrounding inflammation, foreign body lodged in the right lower lobe bronchus, and interbronchial fistula(between right middle and lower lobe bronchus) were seen Foreign body($2.4\{times}1.3cm$ sized antacid package) was removed by flexible bronchoscopy. Later, history of aspiration of a piece of antacid package was found. We report a case of recurrent bronchitis with interbronchial fistula as a result of occult aspiration of foreign body with review of the literatures.

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A Case of Bilateral Pleural Effusion due to Ovarian Hyperstimulation Syndrome (양측 흉수를 동반한 난소과자극증후군(Ovarian Hyperstimulation Syndrome : OHSS) 1례)

  • Kim, Ki-Up;Han, Sang-Hoon;Kim, Do-Jin;Yoon, Bo-Ra;Yoon, Hyun-Soo;Lee, Young-Kyung;Na, Mun-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.636-640
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    • 2001
  • Ovarin hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation, shows varying degrees of clinical manifestations. The pathogenesis of OHSS is an increase of vascular permeability resulting in hypovolemia, thromboembolism, ARDS, and death in sometimes. Pleural effusion is also a result of an increase of vascular permeability in the pleura. Thoracentesis is sometimes required to relieve dyspnea. We report a case of OHSS with bilateral exudative pleural effusion in a 23 year-old female with resting dyspnea. She was received clomiphen, FSH, and LH for the treatment of irregular menstruation twenty days previously. The ultrasonogram showed severe ascites and bilaterally huge ovary, and chest radiography showed bilateral effusion. Therapeutic thoracentesis and paracentesis were done for relief of the dyspnea. Two weeks later the bilataral effusion and symptoms disappeared spontaneously.

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A Case of Forestier's Disease with Dyspnea (호흡 곤란을 동반한 Forestier병 1례)

  • Park, Yong-Hyun;Park, Yoong-In;Jeon, Doo-Soo;Hong, Jin-Hee;Ryu, Ki-Chan;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1094-1097
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    • 1998
  • Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis(DISH), is a peculiar type of senile ankylosing hyperostosis of the spine characterized by flowing ossification of the anterior and right lateral aspect of the vertebral column, particularly in the thoracic region. Although these patients are typically asymptomatic, there is documentation of a number of extraspinal manifestations including dysphagia, respiratory distress, dysphonia and cervial myelopathy. We report a case of Forestier's disease presenting with dyspnea in a 57-year old man, who have chronic cervical pain and bronchiectasis. Forestier's disease was diagnosed by cervical spine X-ray, neck CT. The patient was treated with oral steroid and then improved.

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